11-1194 (SFD). r I
P.O. BOX 1504 VOICE (760) 777-7012
78-495 CALLE TAMPICO FAX (760) 777-7011
LA QUINTA, CALIFORNIA 92253 BUILDING & SAFETY DEPARTMENT INSPECTIONS (760) 777-7153
BUILDING PERMIT
- Date: 5/17/12
Application Number: 11=000"01194 Owner:
Property Address: 54805 AVENIDA VALLEJO DUCHENE EUGENE & MARIE
APN: 774-201-014- - 94 COLUMBUS DRIVE
Application description: DWELLING - SINGLE FAMILY DETACHED RANCHO MIRAGE, CA 92270
Property Zoning: COVE RESIDENTIAL
Application valuation: 126173
Contractor:
Applicant: Architect or Engineer: SUN VALLEY DEVELOPMENT
73900 DINAR SHORE DR. 0 MAY 17 2011
PALM DESERT, CA 92211
/ ^ (760) 832-7406 � CITY OF Lic. No.: 940584 FINAF QUITTA
-------------------------------------------------------------------------------------------------
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business and Professionals Code, and my License is in full force and effect.
License Class: B License 940584
ate: l% ntractI IN 12 A -
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractor's State License Law for the
following reason (Sec. 7031 .5, Business and Professions Code: Any city or county that requires a permit to
construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the
permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State
License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or
that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).:
(_ 1 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and
the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The
Contractors' State License Law does not apply to an owner of property who builds or improves thereon,
and who does the work himself or herself through his or her own employees, provided that the
improvements are not intended or offered for sale. If, however, the building or improvement is sold within
- - one year of completion, the owner -builder will have the burden of proving that he or she did not build or
improve for the purpose of sale.). -
(_) I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec.
7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for the projects with a contractors) licensed
pursuant to the Contractors' State License Law.).
(_) I am exempt under Sec. , B.&P.C. for this reason
Date:
Owner:
CONSTRUCTION LENDING AGENCY
I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the
work for which this permit is issued (Sec. 3097, Civ. C.).
Lender's Name:
Lender's Address:
LQPERMIT
WORKER'S COMPENSATION DECLARATION
I hereby affirm under penalty of perjury one of the following declarations:
I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided
for by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued.
„ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor
Code, for the performance of the work for which this permit is issued. My workers' compensation
insurance carrier and policy number are:
Carrier STATE FUND 07/O1/1Policy Number 1978014-2011
I certify that, in the performance of the work for which this permit is issued, I shall not employ any
person in any manner so as to become subject to the workers' compensation laws of California,
and agree that, if I should become subject to the workers' compensation provisions of Section
3700 of the hall forthwith comp) . h those provisions.
dater$' A ica
WARNING: FAILU Ef ECURE W RKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL
SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND
DOLLARS ($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN
SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
APPLICANT ACKNOWLEDGEMENT
IMPORTANT Application is hereby made to the Director of Building and Safety for a permit subject to the
conditions and restrictions set forth on this application.
1. Each person upon whose behalf this application is made, each person at whose request and for
whose benefit work is performed under or pursuant to any permit issued as a result of this application,
the owner, and the applicant, each agrees to, and shall defend, indemnify and hold harmless the City
of La Quinta, its officers, agents and employees for any act or omission related to the work being
performed under or following issuance of this permit.
2. Any permit issued as a result of this application becomes null and void if work is not commenced
within 180 days from date of issuance of such permit, or cessation of work for 180 days will subject
permit to cancellation.
I certify that I have read this application and state that the above information is correct. 1 agree to comply with all
city and county ordinances and state laws relating to building construction, and hereby authorize representatives -
of this county to enter upon the above-mentioned proper y for inspection purposes. 1' I
YO1C•s
�ignature (Applicant or Agent): -O 1\V►^—/'``T
Application Number .
. . . . 11-00001194
------ Structure.Information
1,972SF DWELLING/VB/RES-3/CLASS A-FR/13D-----
Other struct info . .
. . . CODE EDITION' 2010
## BEDROOMS
3.00
FIRE SPRINKLERS 13D
GARAGE SQ FTG
458.00 .
'
PATIO SQ FTG
20.00
NUMBER OF UNITS
1.00
--------------------------
1ST-FLOOR SQUARE FOOTAGE 1972.00
--------------------------------------------------
_.
PermitELEC-NEW
RESIDENTIAL
Additional desc
Permit Fee
108.18 Plan Check .Fee
27.05
Issue Date
Valuation
0
Expiration Date
10/10/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
1972.00 .0350
ELEC NEW.RES - 1 OR 2 FAMILY
69.02
458.00 .0200
ELEC GARAGE OR NON-RESIDENTIAL
9.'16
1.00 15.0000.EA
-----------------------------------------------------------------------
ELEC TEMPORARY POWER POLE
15:00-
Permit
GRADING PERMIT
Additional desc .
Permit Fee . .
15.00 Plan, Check Fee
.00 .
Issue Date . . . .
Valuation
0
Expiration Date
10/10/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
Permit
BUILDING.PERMIT-
Additional desc ..
Permit Fee . . . .
734.00 Plan Check Fee-.
477.10
Issue Date . . .
Valuation -
126173
Expiration Date
10/10/12
Qty Unit Charge-
Per
Extension
BASE FEE
639.50 .
27.00 3.5000
---------------------------------------7
THOU BLDG 100,001-500,000
------------------------------------
94.50 .
-
Permit . . .
MECHANICAL
Additional desc .
Permit Fee . . . .
71.00 Plan Check Fee
17.75
LQPERMIT
LQPERMIT
Application Number .
. . . . 11-00001194
Permit MECHANICAL
Issue Date . .
Valuation . .
0
Expiration Date
10/10/12
Qty Unit Charge
Per
Extension.
BASE FEE.
15.00
1.00 9.0000
EA MECH FURNACE <=100K
9.00-
1.00 4.5000
EA MECH VENT INST/. DUCT ALT
4.50
1.00 .16.5000
EA MECH B/C >3=15HP/>100K-500KBTU
16.50
3.00 6.5000
EA MECH VENT FAN
19.50
1.00 6.5000
EA MECH EXHAUST HOOD
6.50
Permit . . .
PLUMBING
Additional desc .
' Permit Fee
157.50 Plan Check Fee
39.38
Issue Date . . . .
Valuation . . . .
0
Expiration.Date
10/10/12
Qty Unit Charge
Per
Extension
BASE FEE
15.00
12.00 6.0000
EA PLB FIXTURE
72.00
1.00 15.0000
EA PLB BUILDING SEWER
15.00
3.00 6.0000
EA - PLB ROOF DRAIN
.18.00
1.00 7..5000
EA PLB WATER HEATER/VENT
7.50
°1.00 3.0000
EA PLB WATER INST/ALT/REP ,
3.00
1.00 9.0000
EA PLB LAWN SPRINKLER SYSTEM
9.00
4.00 .7500
EA PLB GAS PIPE >=5
3.00
1.00 15.0000
EA PLB GAS METER
15.00
Special Notes and Comments
1,972SF DWELLING/VB/RES-3/CL
A-FR/13D
(CONVENTIONAL) THIS PERMIT
DOES NOT
INCLUDE BLOCK WALLS,
POOL, SPA, BBQ OR
DRIVEWAY APPROACH. 2010
CALIFORNIA
BUILDING CODES.
April 13, 2012 9:27:26
AM AORTEGA-
------------- ----------- -------------------------------==---------------------
Other Fees . . .
. ART IN_'PUBLIC PLACES -RES
20.00
`
BLDG STDS ADMIN (SB1473)
6.00
DIF COMMUNITY CENTERS -RES
74.00
"DIF CIVIC CENTER - RES
995.00
ENERGY REVIEW FEE
47.71
DIF FIRE -PROTECTION -RES
140.00
GRADING PLAN.CHECK FEE
15:00
DIF -.LIBRARIES -.RES(
355.00
MULTI -SPECIES (MSHCP) FEE'
521.00
DIF PARK MAINT FAC - RES
22.00
LQPERMIT
Application Number
. . . . .
11-00001194 M
-----------------------
- Other Fees
------------
-------------------------
DIF PARKS/REC - RES
---------------
892.00
COVE PRECISE PLAN FEE
100.00
DIF STREET MAINT FAC -RES
67:00
DIF TRANSPORTATION - RES
1930.00
Fee summary.
Charged
Paid Credited
Due
Permit Fee Total
1085.68
.00 .00
10'85:68
' Plan Check Total
561.28
400.00 .00'
161.28
Other Fee Total
5184.71
.00 .00
5184.71
Grand Total
6831.67
'400.00 .00-
6431.67 -
1
LQPERMIT
Building
Address S
Owner
P.O. BOX 1504 APPLICATION ONLY
78-495 CALLE TAMPICO
LA QUINTA, CALIFORNIA 92253
mailing f�b3
Address 7j( bz ACwt-i-Ae t U S �.
div . C� • I O 3 �3
R44 A,4 I lLT Zp ZZ �� Tel.
m. 27TZ•4091
& Classif. I Lic. #
Hrcn., tngr.,
Designer - - , j 7f>-- `raD to, / Asc,
Address Tel.
490 4( o
City ft2,,?_4_-7-
State
Lic. #
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full force and
effect.
SIGNATURE DATE
OWNER -BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following
reason: (Sec. 7031.5, Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also
requires the applicant for such permit to file a signed statement that he is licensed pursuant to
the provisions of the Contractor's License Law, Chapter 9 (commencing with Section 7000) of
Division 3 of the Business and Professions Code, or that he is exempt therefrom, and the basis
for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
the applicant to a civil penalty of not more than five hundred dollars ($500).
❑ I, as owner of the property, or my employees with wages as their sole compensation, will do
the work, and the structure is not intended or offered for sale. (Sec. 7044, Business and Profes-
sions Code: The Contractor's License Law does not apply to an owner of property who builds
or improves thereon and who does such work himself or through his own employees, provided
that such improvements are not intended or offered for sale. If, however, the building or im-
provement is sold within one year of completion, the owner -builder will have the burden of
proving that he did not build or improve for the purpose of sale).
❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct
the project. (Sec. 7044, Business and Professions Code: The Contractor's License Law does
not apply to an owner of property who builds or improves thereon, and who contracts for such
projects with a contractor(s) licensed pursuant to the Contractor's License Law)
❑ 1 am exempt under Sec. B. & P.C. for this reason
WORKER'S COMPENSATION DECLARATION
I hereby affirm that I have a certificate of consent to self -insure, or a certificate of Worker's
Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code.)
Policy No. Company
❑ Copy is filed with the city. ❑ Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the permit is for one hundred dollars ($100) valuation
or less).
I certify that in the performance of the work for which this permit is issued, I shall not
am toy any person in any manner so as to become subject to Workers' Compensation Laws of
California.
Date Owner
NOTICE TO APPLICANT.. If, after making this Certificate of Exemption you should become
subject to the Workers' Compensation Provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work
for which this permit is issued. (Sec. 3097, Civil Code.)
Lender's Name
Lender's Address
This is a building permit when properly filled out, signed and validated, and is subject to
expiration if work thereunder is suspended for 180 days.
I certify that I have read this application and state that the above information is correct.
I agree to comply with all city and county ordinances and state laws relating to building
construction, and hereby authorize representatives of this city to enter the above-mentioned
property for inspection purposes.
Signature of applicant Date
Mailing Address
City, State, Zip
WHITE = BUILDING DEPARTMENT
BUILDING: TYPE CONST. OCC. GRP.
A.P.
Legal Description
Project Descriptior &5(21b L.;r•_M I [.Lf,
Sq. Ft. No. No. Dw.
Size Stories Units
New ®� Add ❑ Alter ❑ Repair ❑ Demolition ❑
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by:
Validated by:
Validation:
Date Permit
YELLOW = APPLICANT PINK = FINANCE
Estimated Valuation /
PERMIT
AMOUNT
Plan Chk. Dep.
,, Q
Plan Chk. Bal.
Const.
Mech.
Electrical
Plumbing _
S.M.I.
_
Grading
Driveway Enc. ; rlu
Infrastructure f
TOTAL
REMARKS
ZONE: BY:
Minimum Setback Distances:
Front Setback from Center Line
Rear Setback from Rear Prop. Line
Side Street Setback from Center Line
Side Setback from Property Line
FINAL DATE INSPECTOR
Issued by:
Validated by:
Validation:
Date Permit
YELLOW = APPLICANT PINK = FINANCE
i
— a
CERTIFICATE`OF COMPLIANCE ���1Ftsc�
Desert Sands Unified School District zqe o
47950 Dune Palms Road ¢ BERMUDA DUNES
RANCHO MIRAGE
Date 5/4/12 La Quinta, CA 92253 INDIAN WELLS
No. 31267 (760) 771-8515 `�� P LA OUINTA ,
. ��INa y�
Owner Eugene & Marie Duchene _ APN # 774-201-014
Address Jurisdiction La Quinta
City Zip Permit #
Tract # No. of Units , 1
Type Single Family Residence "
Lot # No. Street S.F. Lot # No. Street S.F.
Unit 1 54805 Avenida Vallejo . 1972 Unit 6 ,
Unit 2 Unit 7 -
Unit 3 Unit 8
Unit 4 Unit 9
Unit 5 Unit 10
Comments
At the present time, the Desert Sands Unified School District does not collect fees on garages/carports, covered patiostwalkways, residential additions under
500 square feet, detached accessory structures (spaces that do not contain facilities for living, sleeping, cooking, eating or sanitation) or replacement mobile
homes. It has been determined that the above-named owner is exempt from paying school fees at this time'due to the following reason:
EXEMPTION NOT APPLICABLE
This certifies that school facility fees imposed pursuant to •
Education Code Section 17620 and Government Code 65995 Et Seq.
in the amount of $2.97 X 1,972 S.F. or $5,856.84 have been paid for the property listed above and that
building permits and/or Certificates of. Occupancy for this square footage in this proposed project may now be issued.
Fees Paid By CC/Pacific Enterprise Bank' Mark Howard Check No. 6163
Name on the check Telephone 760-272-4691
t
Funding Residential
By Dr. Sharon P. McGehee
Superintendent
` •.K +
Fee -collected /exempted by. SKar n il�[[ey Payment Recd $0.00 -
$5,856.84 s `mer/U_�nder
�� .
tl
Signature C %�`(� ~ • ... '
AA
NOTICE: Pursuant to Government Code Section 66020(d)(1), thl II serve to notify you that the 90 -day approval period in which you may protest the fees
or other payment identified above will begin to run from the date ich the building or installation permit for this project is issued, or from the date on
which those amounts are paid to the District(s) or to another public entity authorized to collect them on the District('s) behalf, whichever is earlier.
NOTICE: This Document NOT VALID without embossed seal
Embossed Original - Building Department Applicant Copy - Applicant/Receipt Copy - Accounting .
RECORDING REQUESTED BY:
Fidelity National Title Company
Escrow No. 14632 -KL
Title Order No. 11 -259929213 -KC
When Recorded Mail Document
and Tax Statement To:
Mr. and Mrs.- Eugene Duchene
94 Columbia Drive
Rancho Mirage, CA 92270
ACAll0A V4 61el,D � '
1ZECEIVTEI: )
MAR 2 6 2012
B)(:
GRANT DEED SPACE.ABOVE THIS LINE FOR
The undersigned grantor(s) declare(s)
Documentary transfer tax is 827.50
[ X ] computed on full value of property conveyed, or
[ ] computed on full value less value of liens or encumbrances remaining at time of sale,
[ ] Unincorporated Arep City of La Quinta
FOR A VALUABLE CONSIDERATION, receipt of which is hereby. acknowledged, Petra Carrillo, A Single Woman
who aquired title as Petra Carillo, A Single Woman
hereby GRANT(S) to Eugene Duchene and Marie H. Duchene, Trustees of the Duchene Family Trust Dated May
7, 1987
the following described real: property in the City. of La 'QuintaCounty of Riverside, State of California:
SEE EXHIBIT "ONE" ATTACHED HERETO AND MADE A PART HEREOF
DATED: September 26, 2011
State of California
County of Riverside
On 2`.21,11 before me,
K. Larbv IJ , Notary Public
(here insert name and title of the officer), personally
appeared Petra Carrillo ,
who proved to me on the basis of satisfactory
evidence to be the person(s) whose name(s) is/are
subscribed to - the within instrument and
acknowledged.to me that he/she/they executed the
same in his/her/their authorized capacity(ies), and that
by his/her/their signature(s) on the instrument the
person.(s),. or the entity upon behalf of which the
person(s) acted, executed the instrument:
I certify under PENALTY OF PERJURY under.the laws'
of the State of California that the foregoing paragraph
is true and correct.
WITNES�andoffilclalal.
Sig ture(Seal)
Petra Carrillo
K. LARBY
Commission # 1834166
Z .� Notary Public - California =
Z Riverside County f
My Comm. Expires Feb 17.2013
MAIL TAX STATEMENTS AS DIRECTED ABOVE
FD -213 (Rev 12/07) GRANT DEED
(grant.wpd)' (08-09)
M'DISTRICT- PLANNING REVIEW FORM
This form is to be used by CDD staff for review of single family dwel.lings - in the RC -(Cove
Residential) District per Section 9.50.090 -of the Zoning Code. Its purpose is -to determine.-, 1.)
that the proposed: housing design does not duplicate the same- architectural style -of any house
within 200 feet of the applicant; .and/or 2) if there is a need for the applicant to file for Master
Design Guidelines. If the applicant does need.to file a Master Design'Guidefine, please transmit '
this information to the Building and' Safety Departmentas- part of your. correction list. Please.
attach additional 'explanations as necessary.
APPLICANT:
.SITE ADDRESS:
APN - . - CASE NO..:
LEGAL: LOT BLOCK UNIT S.C.@V.L:Q.
CHECK AND APPROVED.BY: C.ZLC ec�s* DATE: Z14 61-
Inform the assigned Building plan. checker upon .your assignment to this case. The CDD
Executive Secretary+ maintains a log book to track applications. and assign case numbers.
REQUIRED ITEM
Y
N
COMMENT/CORRECTION
Verify legal and APN information
Consistent with MDG•on file (as
applicable)
.MDG filing required (5' filings
since 9/3/98)
.`
Architectural variety within 200
feet of the surrounding area:
Architectural design features
=
'
Other Requirements:
�'
Plan Submittal
Job Site
Owner's Ni
Number, Street, or PO
City, State, Postal C
Owner's Phone Nun
Owner's E -Mail Addi
Project Manager's
Project Manager's Phone P
Project Manager's E-mail A
Building Permit Number:
Project Description: NSFR
Exempt: ❑
(Materials may contain hazardous wastes and
are not subject to recycling provisions)
Construction Debris Management Plan
1/412012
54805 Avd. Vallejo
EI Rancho Homes
PO Box 10389
Palm Desert, Ca 92255
Mark Howard
760-272-4691
lenchdeslgn0aol.com
BulIdor/ Con tracto
EI Rancho Homes
Number, Street or Po Bo
PO Box 10389
City, State, Postal Cod
Palm Desert, Ca 92255
Project Square Footag
2,392
City Approval By
Date of City Approval
Materials To Be Discarded:
. /
Product
Tons
Trash
4.54
Not recyclable
Asphalt
0
Recyclable
Brick/Block
0
Recyclable
Cardboard
0.79
Recyclable
Commingled
0
Recyclable
Concrete
0.19
Recyclable
Drywall
0.14
Recyclable
Donated / Reuse*
0
Recyclable
`Describe Items
Product
Masonry (broken)
Plaster
Scrap Metal
Tile (floor)
Tile (roof)
Wood
Landscape Debris
Tons
0 Recyclable
5.98 Recyclable
0 Recyclable
Totals: Recycle Trash Projected Diversion:
7.991 1 4.54 63.8%
I understand it is the property owner's responsibility to submit copies of weight tickets or receipts to the District
Environmental Coordinator as these hauls occur. I hereby certify that completion, Implementation and adherence of the
Debris Management Plan (DMP) for the above named project shall guarantee that at least 50% of the jobsite waste Is diverted
from landfilling. The remaining material will be recycled or reused. I will divert, for recycling or re -use, remaining materials
generated from the first day of the project through the completion of the project In accordance with this plan. This DMP Is
Issued in the name of the property owner(s) and shall remain their property throughout the construction and/or demolition
project. A contractor serving as agent of the owner may obtain a DMP for the owner. However; the DMP Is still Issued In the
name of the property owner(s) and the owner retains legal responsibility for ensuring that the provisions of the DMP are adhered
to. The prorly owners) and general contractor shall be kept Informed of the diversion progress through bl-monthly reports. If
self-haulin , all r fuse material from this project site must be taken to an approved racycI r or tr nsfer station.
.....Owner./. Deve oper. /.Project Manager / Superintendent .................... ........ .................... ........................ Dae ........ ..... ......... ... ................ .... _................. ....................... .
k
Monthly Recycling Progress Report
oF As of: October' 17, 2012
Your participation in the City of La Quinta's Construction
Debris Program ensures that your worksite remains in.
compliance at all times with State mandates requiring
the reduction of materials going to California's landfills:
Your project's progress is being monitored by the
franchised hauler's District Environmental Coordinator_
who is available for consultation regarding additional
recycling opportunities for the duration of your project.
The percentages in the boxes to the right represent the
current amount of materials removed from your project
versus the recycling goal established at the beginning of
the job. Below is the breakdown of materials (plan v.
actual) since the start of your project.
Since recycling costs are generally lower than landfilling
your material, you are saving money on each ton you
divert.
If you are having difficulty meeting this projection,
please contact the District Environmental Coordinator at
(760) 578-5215 for assistance.
Planned
Tons
Recycled/Reused
Materials
Actual
Tons
0.00
Asphalt
0.00
0.00
Brick/Block
0.00
0.79
Cardboard
0.00 '
0.00
Comin led C&D Material
0.00
0.19
Concrete'
0.00
0.14
Drywall
0.00
0.00
Items Donated or Reused
0.00
0.00
Landscaper Debris
0.00
0.00
Mason broken
0.00.
0.48
Plaster
0.00
0.00
Scrap Metal
0.00
0.41
Tile floor
0.00
0.00
Tile (rooD
0.00
5.98
Wood
1.35
_ Project Contact
Mark Howard
P_r__oject_Lo_ca_tion
54805 Avd. Vallejo `
Property Owner's Mailing Address
EI Rancho Homes '
PO Box 10389 ~
Palm Desert, Ca 92255 "
E-mail: -
Contractor's Mailing_ Address ,
EI Rancho Homes
PO Box 10389 -
Palm Desert, Ca 92255 -
E-mail: howmark22@aol.com
Project square Foota el 2,392
Recycling Goal
64
1 ,
Actual Recycling
51%
r
No more than 50% of jobsite waste from
new construction may:be,disposed of as
trash. The remaining -material must be
'recycled or, re -used.
Green Building Standards Code 4.408 &5.408
If you are self -hauling recyclables or trash, please send
copies of receipts or weight tickets to:
Kenn Stevens, DEC
41-575 Eclectic Street, Palm Desert, Ca 92260
Fax: 760 340-0417 E-mail: ken@burrtecdesert.com .
�otai Kecyclea.��J
Project Type: I NSFR
Planned Non -Recycled Actual
4.54 Trash 1.30 Project started on or about: 11/4/2012
- Certificate of Insulation d-
This certifies that insulation has been professionally installed in this project to provide
thermal values as noted below in accordance with California, Energy Standards,' Title" 24:
i
Your project has been insulated with. 4 Johns Manville ' - + ' Greenguard Certified
Insulation,materials.that are designed;to meet'or exceed current energy requirements• and
safety standards. All products used have been installed in 'a professional and proper manner.
Job: New Single Family Dwelling ' - Completion Date: 7/24/20.12
Address: 54805 Ave. Vallejo,' La Quinta, CA
Areas insulated to meet or exceed requirements: R -Value (*) Type
Ceiling area.. 38'Fiberglass Batt
Exterior walls 13 Fiberglass Batt
Y!
Title 24 Caulking ? ... - . Poly Foam Caulking
Optional Areas Insulated:
Garage ceiling area '` 19 Fiber lass Batt
- Gara a exterior walls ' 11 t Fiber Iass,Batt
R -Value(*) e - Tvpe
* R=value means resistance to heat flow. The higher the R -value the greater it's insulating power, A
fact sheet on R -values is available upon request. This'document should stay -with the.home if sold.
Signed: NXWbt21dIC�in., ;
_ Michael L. Dickerson - President
i Pro Insulation, Inc -
• . • P.O. Box -10306 _
San'Bernardino, CA 92423
- www.proinsulationinc.com
4
Certificate of Occupancy
Building & Safety Department
This Certificate is issued pursuant to the requirements of Chapter 1 Section R110 of the
California Residential Code, certifying that, at the time of issuance, this structure was in
compliance with the provisions of the Building Code and .the various ordinances of the City
regulating building construction and/or use.
BUILDING ADDRESS: 54-805 AVENIDA VALLEJO
Use classification: SINGLE FAMILY DWELLING
Occupancy Group: R3 Type of Construction: VB
Code Edition: 2010 Sprinkler Installed: YES
Building Permit No.: 11-1194
Land Use Zone: RC
Sprinkler Required: YES
Owner of Building: DUCHENE EUGENE & MARIE
Address:
City, ST, ZIP:
By:
Building Official Date:
POST IN A CONSPICUOUS PLACE
94 -COLUMBUS DRIVE
RANCHO MIRAGE, CA 92270
AJ ORTEGA
OCTOBER 17, 2012
IN COOPERATION WITH
THE CALIFORNIA DEPARTMENT -OF FORESTRY AND FIRE PROTECTION
`77-933 Las' Montanas Rd:; Ste: #201, Pa Inni Desert';.CA - 92211-4131 •. Phone • (760) 863--8886` ' ; • .` ;> t
• Fax (760) 863-7072
www.rvcfire..org
PROUDLY SERVING THE
UNINCORPORATED AREAS February 8, 2012
OF RIVERSIDE COUNTY ry .
AND THE CITIES OF:
Desert Fire Extinguisher
BANNING 558 E. Industrial Place
BEAUMONT Palm Springs, CA 92262
CAUMESA Re: Residential Fire Sprinkler Plan Review
CANYON LAKE 54-805 Ave Vellejo
COACHELLA
DESERT HOTSPRINGS The Riverside County Fire. Department Planning & Engineering personnel have reviewed your
sprinkler plans for -the above referenced project. Please be advised that your plans require the
EAsTVALE following corrections.
INDIAN WELLS
Please provide the following information in your next submittal:
INDIO
LAKE ELSINORE 1) Provide a recent (within 6 months) water flow verification letter from the water purveyor
2) Provide hydraulic calculations based on the ACTUAL water flow
LAQUINTA' 3). Provide Materials Data Sheets for:
MENIFEE -Fire Sprinklers
-Pipe, fittings and devices
MORENO VALLEY -Water supply components devices such as water meter, backflow, ect.
PALM DESERT 4) Building system piping plan including all of the following that apply:
-Size and type of all pipe and fittings, with length.of each segment and actual
PERRIS inside diameter used for hydraulic calculations.
RANCHO MIRAGE -Location of all hangers and means of support.
-Reference nodes matching hydraulic calculations
RUBIDOUx CSD
SAN JACINTO NO inspections will be performed until Riverside County Fire Department Planning &
TEMECULA Engineering staff has approved the corrected plans.
WILDOMAR
All questions regarding the meaning of these conditions should be referred to the Fire
Department Planning & -Engineering staff at (760) 863-8886.
BOARD OF
SUPERVISORS: Sincerely,
BOB BUSTER
DISTRICT 1
JOHN TAVAGLIONE
DISTRICT 2 Jason Stubble
JEFF STONE Fire Safety Specialist
DISTRICT 3
JOHN BENOIT
DISTRICT 4
MARION ASHLEY
DISTRICT 5
C,y
M
1
CITY OF LA QUINTA SUB -CONTRACTOR LIST '
JOB ADDRESS �/ O /7YE V/�y PERMIT NUMBER - D000 / OWNER int/Li- Th: BUILDER EZ- AIKI&VA
This form shall be posted•on the job with the Building Inspection Card at all times in a consp•cuous place. Only persons appearing on this list or their employees are authorized to work
on this job. 'Any -changes to this list must be approved by the Building Division prior to commencement of work. Failure to comply will result in a stoppage of work and/or the voidance
of hiiilriinn nprmit Fnr path annlirtahlp trade- all infnrmatinn renuested below must be completed by aDDlicant. "On File" is not an acceptable response.
Trade / Classification
Contractor :.:.:::.:.:::
:• :'1� ... .....::..:
;:':<'>:.:::>::>:<.;:.:::.;:::::
:..... ...State Contractor s License
rk r m ensation':Insurance:.;::': ;';:>.::.'.:;
Wo e.s Co
City Busriegs licensi..'.
Company Name
Classification
(e.g. A, B, C-8)
License Number
(xxxxxx)
Exp. Date
(xx/xx/xx)
Carrier Name
(e.g. State Fund, CalComp)
Policy Number
(Format Varies)
Exp. Date
(xx/xx/xx)
License Number
(xxxx)
Exp. Date
(xx/xx/xx)
EARTHWORK (C-12).:.;
=
CONCRETE (C-8), >
E'eY DUDE C�VN5T
e-$
O� ��'%S
-9/111/3
�4x& r"
o0o2-$3-(o120
FRAMING :lC-51 ;..''
5,jr.S (/4V VV
C_ - s B
14f 0'5
i2 ;
c `f 7 P 14Wff ..
/
STRUCT'.:STEEL'(C-51)
-¢-
MASONRY (C•29)
PLUMBING (C-361
Gj " PW Nc g t N C7
' ri 3(.
B %� 7 IgS
/ �$ 10. -It
% !/
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f_ATH; PLASTER (C.35)
�& tJ Go +
G=. 3S
7Z7 Cob
1 3/ 1
ori
3&.11011508Z-_
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DRYWALL (C-9),.>..:
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HVAC. (C-20)::: '`. '
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C-�
731
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ELECTRICAL. (C=1 0) :. ..
(3ttt. (.�� Cz EDT •
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p��1Z6T
ROOFING .IC.=39► ` >': .:
`C 126AFtN�o
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Co �o
j
( 7 F � S 1�
SHEET.METAL IC -43)'
-�—
FLOORING lC::15).; :;:` : '
D &i7 G4-tzP�T'
C--1 S
5"J 2,0; $
GLAZING (C-171.
INSULATION (C-2) :
PV-� SUS t, 0 �:Rx-
G -Z
G
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ff__
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r IQ,¢�?D/2 l / S,
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SEWAGE DISP - (d. -4'24
PAINTING
CERAMIC TILE (C-54)
CABINETS (C-6)
7U�/ ✓A t �'t(. 'Dev q IJC ,
FENCING (C-13)
tJDt2 OO N S
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LANDSCAPING (C=27)..;:
POOL (C-53)
Note: If installation of a Charge Indicator Display (CID) is utilized as an alternative to refrigerant charge verification for -
compliance, a MECH-24 Certificate (instead of this MECH-25 Certificate) should be used to demonstrate compliance with '
the refrigerant charge verification requirement. TMAH and STMS are not required for compliance, when a CID is utilized
for compliance.
As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an additional form(s) for,'
any additional systems in the dwelling as applicable.-
Temperature
pplicable.Temperature Measurement Access Holes (TMAH) and Saturation Temperature Measurement
Sensors (STMS)'
Procedures for installing TMAH are specified in Reference Residential Appendix RA3.2. If refrigerant charge verification is.
required for compliance, TMAH are also required for compliance. STMS are only required for completely new or
replacement space -conditioning systems that utilize prescriptive compliance method. °•
TMAH - Access Holes in Supply and Return Plenums of Air Handler
System Name or Identification/Tag
Split System
System Location or Area Served
Garage
1
® Yes
❑ No
5/16 inch (8 mm) access hole upstream of evaporative coil in the return plenum and
labeled according to Figure in Section RA3.2.2.2.2.
2
®Yes
13 No
5/16 inch (8 mm) access hole downstream of evaporative coil in the supply plenum
and labeled according to Figure in Section RA3.2.2.2.2: }
Yes to 1 and.2 is a pass.
- Enter Pass or Faill ✓ a Pass ✓•❑ Fail
STMS - Sensor_.on;the. Evaporator Coil-
System Name 'or Identification/Tag-) / :./j Split System !. '` "' /r' j j ( V _
3
❑ Yes
❑�N
r�
The sensor is factory installed, orifield installed according to manufacturer.'s .
specifications, or is installed by methods/specifications approved by the Executive
6
❑ Yes
; .. /
Director.
The sensor wire is terminated -with a standard mini plug suitable for connection;to a
4
❑ Yes
, - ❑ No
digital thermometer. The"`sensor-mini plug is accessible to the.installing;techniciari
7
'
-
and the HERS rater without changing the airflow through the condenser coil `
5
13 Yes
❑ No {
When attached to a digital thermometer, the sensor provides an indication of the
8
_
❑ No
saturation temperature of the coil.
Yes to 3, 4, and 5 is a pass. Enter. N/A if STMS are not
applicable. Otherwise enter Pass o� Fail''
✓ ®N/A ;
✓ -13 Pass
✓ [3 Fail
STMS - Sensor on the Condenser Coil
System Name or Identification/Tag Split System
-
✓ ®N/A
✓ �,❑Pass
The sensor is factory installed, or field installed according to manufacturer's
6
❑ Yes
❑ No
specifications, or is installed by,methods/specifications approved by the Executive
Director.
The sensor wire is terminated with a standard mini plug suitable for connection to a
7
❑ Yes
❑ No
digital thermometer. The sensor mini plug is accessible to the installing technician
Reg: 212-A0054093A-M2500001A-M25A • Registration
Date/Time: 2012/09/28
and the HERS iat& without changing the airflow through the condenser coil
8
❑ Yes
❑ No
When attached to a digital thermometer, the sensor provides an indication of the
March 2010
saturation temperature of the coil.
Yes to 6, 7, and 8 is a pass. Enter N/A if, STMS are not
-
✓ ®N/A
✓ �,❑Pass
✓ [3 Fail
-
applicable. Otherwise enter Pass or Fail •
Reg: 212-A0054093A-M2500001A-M25A • Registration
Date/Time: 2012/09/28
01:23:'59. HERS
Provider: CalCERTS, Inc.
2008 Residential Compliance Forms
March 2010
Standard Charge Measurement Procedure (for use if outdoor air dry-bulb is above 55°F) '
Procedures for determining Refrigerant Charge using the Standard Change Measurement Procedure are available in Reference Residential ,
Appendix RA3.2: As many as 4 systems in the dwelling can be documented for complianceusing this form. Attach an additional form(s) for,
any additional systems in the dwelling as applicable. ° t '
• The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure:
• The system must meet minimum airflow requirements as prerequisite fur a valid refrigerant charge test.
• If outdoor air dry-bulb is 55°f or below, the. installer must use the Alternate Charge Measurement Procedure.
Space Conditioning Systems _
z
System Name or Identification/Tag
--9/l/2012
Split System
System Location or Area Served
- 9/1/2012
Garage
I f
Outdoor Unit Serial # f
' ,W1F11O7638
Outdoor Unit Make n
Guardian
Outdoor Unit Model
r,
GCGSD6OS41S3A
,
Nominal Cooling Capacity Btu/hr
a
r
60000
r
Date of Verification �
`
9/27/2012
E
Calibration of Diagnostic Instruments.
Date of Refrigerant Gauge Calibration
--9/l/2012
(must be re -calibrated monthly)
'
Date of Thermocouple, Calibration f %�
- 9/1/2012
rye-
must be re -calibrated monthly)
I f
' Measured Temperatures (°F) /. f
Reg: 212-A0054093A-M2500001A-M25A 'CRegistration Date/Time: 2012/09/28 01:23:59 HERS Provider: Ca10ERTS'- Inc.
2008 Residential Compliance Forms ., March 2010 r
System Name or Identifit�catyiionirTag, SplitiSystem
toX111 -. ')1
Supply (evaporar leaving)'air dry-bulb
temperaturedb),
temperature (Tsu I db)
Return (evaporator entering) air dry-bulb t ,
temperature (Treturn, db) ?
Return (evaporator entering) air wet -bulb
temperature (Treturn, wb)
Evaporator saturation temperature
39.7
(Tevaporator, sat) r
Condensor saturation temperature 101.3 -
(Tcondensor, sat) -
Suction line temperature (Tsuc'on) 56.6
Liquid Line Temperature (Tliquid) r ' 94.3
Condenser (entering) air dry
-bulb
94
temperature (T condenser -
, db) s
Reg: 212-A0054093A-M2500001A-M25A 'CRegistration Date/Time: 2012/09/28 01:23:59 HERS Provider: Ca10ERTS'- Inc.
2008 Residential Compliance Forms ., March 2010 r
System Name or Identifit�catyiionirTag, SplitiSystem
toX111 -. ')1
Supply (evaporar leaving)'air dry-bulb
temperaturedb),
temperature (Tsu I db)
Return (evaporator entering) air dry-bulb t ,
temperature (Treturn, db) ?
Return (evaporator entering) air wet -bulb
temperature (Treturn, wb)
Evaporator saturation temperature
39.7
(Tevaporator, sat) r
Condensor saturation temperature 101.3 -
(Tcondensor, sat) -
Suction line temperature (Tsuc'on) 56.6
Liquid Line Temperature (Tliquid) r ' 94.3
Condenser (entering) air dry
Minimum Airflow Requirement - -
w
Temperature Split Method Calculations for determining Minimum Airflow Requirement for Refrigerant Charge`
Verification. The temperature split method is specified in Reference Residential Appendix RA3.2..
System Name or, Identification/Tag
-
Calculate: Actual Temperature Split = Tretum,
db - Tsupply, db '
Target Temperature Split from Table RA3.2-3
using Tretum, wb and Tretum, db
'
Calculate difference: Actual Temperature Split -
Target Temperature Split='
,
Passes if difference is between -4°F and +4°F or,
{
upon remeasurement, if between -4°F and
e
-100°F r `
ay"
r
-
Enter Pass or Fail
r.
Note: Temperature Split Method Calculation is not necessary if actual Cooling Coil Airflow is verified using one of the
airflow measurement procedures specified in Reference Residential Appendix RA3.3: If actual cooling coil airflow is
measured, the value must be equal to or greater than the Calculated Minimum Airflow Requirement in the table below.
Calculated Minimum Airflow Requirement (CFM) ='Nominal Cooling Capacity, (ton) X 300 (cfm/ton)
System Name or Identification/Tag ? R
Split S stem
t
.y
Calculated Minimum Airflow Requirement (CFM)
1Soo
Measured Airfl�:.u.sin RA3.3.procedures CFM
1895'
-,
Passes if measured airflow is greater than or -
equal to the calculated minimum airflow
-
PASS
-
requirement:,
Enter Pass or Fail`
2
System passes if difference is between. -6°F and
Reg: 212-A0054093A-M2500001A-M25A Registration Date/Time: 2012/09/28 01:23:59 "HERS Provider: Ca10ERTS,.Inc.
2008 Residential Compliance Forms k March 2010
Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used
for fixed orifice metering device systems
System Name or Identification/Tag a w
Calculate: Actual Superheat
Tsuction - Tevaporator, sat
Target Superheat from Table RA3.2-2 using "
Tretum, wb and Tcondenser, db
Calculate difference:
Actual Superheat - Target Superheat =
Enter Pass or Fail,
-
System passes if difference is between. -6°F and
Reg: 212-A0054093A-M2500001A-M25A Registration Date/Time: 2012/09/28 01:23:59 "HERS Provider: Ca10ERTS,.Inc.
2008 Residential Compliance Forms k March 2010
Superheat Charge Method Calculations for Refrigerant Charge Verification. This procedure is required to be used
for fixed orifice metering device systems
System Name or Identification/Tag a w
Calculate: Actual Superheat
Tsuction - Tevaporator, sat
Target Superheat from Table RA3.2-2 using "
Tretum, wb and Tcondenser, db
Calculate difference:
Actual Superheat - Target Superheat =
Enter Pass or Fail,
Subcooling Charge Method Calculations for Refrigerant Charge Verification. This procedure is required.to be used,
''
for thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. n
System Name or.Identification/Tag
Split System
Calculate: Actual Subcooling =
7"W
'
Tcondenser, sat - Tliquid
'
Target Subcooling specified by manufacturer
r- , 10
Calculate difference:
; :g
}
Actual Subcooling - Target Subcooling =
N41—
_
f �
J
passes if difference is between'i•+
'PASS
.
•.
f
'
d +40F`'
EF
PASS
' i
,
" ; Enter Pass or Fail
-
{
> .
- '
Metering Device Calculations for Refrigerant Charge Verification. This procedure.is required to be used for
thermostatic expansion valve (TXV) and electronic expansion valve (EXV) systems. ;
System Name or Identification/Tag T
Split System'.
Calculate: Actual Superheat =
Tsuction - Tevaporator; sat
16.9
'
Enter allowable superheat range from
'
manufacturer's specifications (or use range
- 16.9
between 3°F and 26°F if nianufacturer'st
specification is not available).
System passesrif actual superheat is within'th
N41—
_
f �
J
allowable superheat range)
'PASS
.
•.
f
'
+ +,^Enter Pass or Fail
' 1 ,
' i
r ; .'
{
Reg: 212-'A0054093A-M2500001A-M25A Registration Date/Time: 2012/09/28 01:23:59 HERS Provider: Ca10ERTS,,Inc.
2008 Residential Compliance Forms r •` March 2010
INSTALLATION CERTIFICATE CF-4R-MECH-25
Refrigerant Charge Verification Standard Measurement Procedure (Page 5 of S)
Site Address: Enforcement Agency: Permit Number:
54805 Avenida Vallejo, La Quinta CA 92253 City of La Quinta 11-1194
Standard Charge Measurement Summary: 1. "
System shall pass both refrigerant charge criteria, metering device criteria (if applicable), and minimum cooling coil
airflow criteria based on measurements taken concurrently during system operation. If corrective actions were taken, all
applicable verification criteria must be re -measured and/or recalculated.
System Name or Identification/Tag
Split System
731939
HERS Provider Data Registry Information
r
System meets all refrigerant charge and airflow
•
,
a HERS sample group
requirements. 1
• . PASS
Rapid Duct Testing & Air Balancing
Responsible Rater's Name:
Responsible Rater's Signature:
Enter Pass or Fal
Saro Jankozian
Responsible Rater's Certification Number w/ this HERS Provider:
Date Signed: 9/27/2012 .
CC2005931
z
DECLARATION STATEMENT -
. I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.
. I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater).
. The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the
Installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified:
on the Certificate(s) of Compliance (CF -SR) approved by the local enforcement agency. i
. The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s)
responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -SR) approved by the `
enforcement agency. _
Builder or Installer information as shown on the Installation Certificate. (CF -6R)
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
RAYBURN HEATING AND AIR CONDITIONING
Responsible Person's Name:
CSLB License:
Doug Rayburn
731939
HERS Provider Data Registry Information
Sample Group * (if applicable): N/A
® tested/verified dwelling, •
❑ not-tested/verified dwelling in'
a HERS sample group
HERS Rater Information CaICERTS Certificate # CC1-1798695425
HERS Rater Company Name: -
Rapid Duct Testing & Air Balancing
Responsible Rater's Name:
Responsible Rater's Signature:
Saro 7ankozian
Saro Jankozian
Responsible Rater's Certification Number w/ this HERS Provider:
Date Signed: 9/27/2012 .
CC2005931
t
Reg: 212-A0054093A-M2500001A-M25A Registration Date/Time:'2012/09/28 01:23:59 'HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms _ March'2010
ai
CERTIFICATE OF FIELD VERIFICATION & DIAGNOSTIC TESTING = CF-4R-MECH-22
HSPP/PSPP Installation: Fan Watt Draw Test (Page 1 of 2)
Site Address:t. Enforcement Agency: Permit Number:
54805 Avenida Vallejo, La Quinta CA 92253 City of La Quinta 11-1194
As many as 4 systems in the dwelling can bedocumentedfor compliance using this form. Attach an additional form(s) for
any additional systems in the dwelling as applicable.
'Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed
Static Pressure Probe (PSPP) in the supply plenum
When the Certificate of Compliance (CFIR )indicates Cooling Coil Airflow or Fan Watt Draw verification are required, HSPP
or PSPP are required to be installed in each air handler in the dwelling. Procedures for installing HSPP and PSPP are
described in Reference Residential Appendix RA3.3. This measure requires verification by a HERS rater.
Select one method from the two choices below for compliance with the HSPP/PSPP requirement for this dwelling.
®
HSPP
1/4 inch (6 mm) hole labeled and located downstream of the -evaporator coil in the supply
® Diagnostic Fan+Flow Using Flow Capture Hood -according to,the procedures in RA3:3.3.1.3
System Name or Identification/Tag `1 ` "�
plenum as shown in the figure in Section RA3.3.1.1.
-
1/4 inch (6 mm) hole equipped with a permanently installed pressure probe, labeled and located
13
PSPP _
downstream of the evaporator coil in the supply plenum as shown in the figure in Section ,
RA3.3.1.1. '
System Name or Identification/Tag
Split System
_
System
System Location or Area Served
Garage
Nominal Cooling Capacity (ton) of the outdoor unit.
5
Confirm that a HSPP or PSPP has been
Enter the minimum airflow requirement from the CF -1R (CFM/ton).
350
CFM/ton
installed on the air handler per the.
PASS
,
Calculate the target minimum airflow for the test by multiplying the CFM/ton
requirements of RA3.3.1.1. '
criteria specified on the CF -1R by the nominal cooling capacity of the outdoor
1750
Enter Pass or Fai
unit (ton).
Cooling Coil Airflow Verification
When the Certificate of Compliance indicates Cooling Coil Airflow verification is required, the procedures for measuring the cooling coil
airflow must be performed as specified in Reference Residential Appendix RA3.3. Results of the cooling coil airflow diagnostic test must be
entered in the table below. This measure requires verification by a HERS rater.
Select onermethod from the three choices'below forLcompliance with the Cooling'Coil Airflow test requirement for this
dwelling. f +'t # i' !• r % s �� r.. 4
❑ Diagnostic Fan Flow Usi,ng,,Plenum Pressure Match ing'according to the procedures' injRA3.3.3.1.1, -N V'
❑ Diagnostic Fan FIowiUsing Flow Grid lMeasurem- ent according to the procedures in RA3.3.3.1.21
® Diagnostic Fan+Flow Using Flow Capture Hood -according to,the procedures in RA3:3.3.1.3
System Name or Identification/Tag `1 ` "�
Split
f
System
System Location or Area Served
Split
_
System
Nominal Cooling Capacity (ton) of the outdoor unit.
5
Enter the minimum airflow requirement from the CF -1R (CFM/ton).
350
CFM/ton
Calculate the target minimum airflow for the test by multiplying the CFM/ton
criteria specified on the CF -1R by the nominal cooling capacity of the outdoor
1750
unit (ton).
Target (CFM)
Enter the diagnostically tested airflow (CFM).
189S.
Tested (CFM)
The system complies if Tested (CFM) is equal or greater than Target (CFM).
PA55
- - • Enter Pass or Fail
Y
Reg: 212-A0054093A-M2200001A-M22A ,Registration Date/Time: 2012/09/28 01:22:14 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms r x March 2010
- a
When the Certificate of Compliance indicates Fan Watt Draw. verification is required, the procedures for measuring the Fan Watt Drawmus
be performed as specified in Reference Residential Appendix RA3.3. Results of the Fan Watt Draw diagnostic test must be entered in the
table below. This measure requires verification by a HERS rater. Note: Fan watt draw must be measured simultaneously with cooling coil
airflow. The fan watt draw measurement and cooling coil airflow measurement must simultaneously meet or, exceed their target criteria
cnE ifiprl by the rF-1R fnr tha dwPBinn_ +
Select one method from the two choices below for compliance with the Fan Watt Draw test requirement for this dwelling.
® Portable Watt Meter Measurement according to the procedures in RA3.3.2.2.1
p Utility Revenue Meter Measurement according to the procedures in RA3.3.2.2.2
System Name or Identification/Tag
Split System
Doug Rayburn
173'1939 `
HERS Provider Data Registry Information
System Location or Area Served
Garage
❑ not-tested/verified dwelling in
la
Enter the air handler Tested (CFM) from the cooling coil airflow test table.
1895
HERS Rater Company Name:
Rapid Duct Testing & Air Balancing
Responsible Rater's Name:
above.
Saro Jankozian
Saro Jankozian
Responsible Rater's Certification Number w/ this HERS Provider:
Date Signed: 9/27/2012 y
Enter the fan watt draw requirement from the CF -1R (Watt/CFM).
•58
Watt/CFM
Calculate the target maximum Watt draw for the test by multiplying the
Watt/CFM criteria specified on the CF -1R by the air handler Tested (CFM).
1099.1
,
Target'(CFM)
Enter the diagnostically tested Watt draw (Watt).
982
Tested (Watt)
s
The system complies if Tested (Watt) is less than or equal to Target (Watt)
PASS
Enter Pass or Fail
G :� - +'- •-•--ter ' f
DECLARATION STATEMENT, `
. I certify under penalty of, perjury, under the laws of the State of California, the information provided on this form is true and correct.
. I am the certified HERS rater who performed the verification services identified and reported on this certificate (responsible rater).." >
. -The installed feature, material, component, or manufactured device requiring HERS verification that is identified on this certificate (the _
installation) complies with the applicable requirements in Reference Residential Appendices RA2 and RA3 and the requirements specified
on the Certificate(s) of Compliance (CF -111) approved by the local enforcement agency.
. The information reported on applicable sections of the Installation Certificate(s) (CF -611), signed and submitted by the person(s)
responsible for the installation conforms to the requirements specified on the Certificate(s) of Compliance (CF -1R) approved by the
enforcement agency. ,
Builder or Installer information as shown on the Installation Certificate (CF -611)
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
RAYBURN HEATING AND AIR CONDITIONING
Responsible Person's Name: -
CSLB License:
Doug Rayburn
173'1939 `
HERS Provider Data Registry Information
Sample Group # (if applicable): N/A
® tested/verified dwelling
❑ not-tested/verified dwelling in
la
HERS sample group
HERS Rater Information CaICERTS Certificate # CC1-1798695425
HERS Rater Company Name:
Rapid Duct Testing & Air Balancing
Responsible Rater's Name:
Responsible Rater's Signature:
Saro Jankozian
Saro Jankozian
Responsible Rater's Certification Number w/ this HERS Provider:
Date Signed: 9/27/2012 y
CC2005931
Reg: 212-A0054093A-M2200001A-M22A Registration Date/Time: 2012/09/28 01:22:14 ITERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE CF-611-MECH-22-HERS
HSPP/PSPP Installation; Cooling Coil Airflow & Fan Watt Draw Test (Page 1 of 2)
Site Address: Enforcement Agency: Permit Number:
54805 Avenida Vallejo, La Quinta CA 92253 1 City of La Quinta 11-1194
As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an
additional form(s) for any additional systems in the dwelling as applicable
Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed
Static Pressure Probe (PSPP) in the supply plenum
When the Certificate of Compliance (CF1R )indicates Cooling Coil Airflow or Fan Watt Draw verification are
required; HSPP or PSPP are required to be installed in each air handler in the dwelling. Procedures for
installing HSPP and PSPP are described in Reference Residential Appendix RA3.3. This measure requires '
verification by a HERS rater.
Select one method from the two choices below for compliance with the HSPP/PSPP requirement for this dwelling.
®
HSPP.
1/4 inch (6 mm) hole labeled and located downstream of the evaporator coil in the supply
1►
,
INSTALLATION CERTIFICATE CF-611-MECH-22-HERS
HSPP/PSPP Installation; Cooling Coil Airflow & Fan Watt Draw Test (Page 1 of 2)
Site Address: Enforcement Agency: Permit Number:
54805 Avenida Vallejo, La Quinta CA 92253 1 City of La Quinta 11-1194
As many as 4 systems in the dwelling can be documented for compliance using this form. Attach an
additional form(s) for any additional systems in the dwelling as applicable
Hole for the placement of a Static Pressure Probe (HSPP), and Permanently installed
Static Pressure Probe (PSPP) in the supply plenum
When the Certificate of Compliance (CF1R )indicates Cooling Coil Airflow or Fan Watt Draw verification are
required; HSPP or PSPP are required to be installed in each air handler in the dwelling. Procedures for
installing HSPP and PSPP are described in Reference Residential Appendix RA3.3. This measure requires '
verification by a HERS rater.
Select one method from the two choices below for compliance with the HSPP/PSPP requirement for this dwelling.
®
HSPP.
1/4 inch (6 mm) hole labeled and located downstream of the evaporator coil in the supply
® Diagnostic Fan Flow Using Flow Capture Hood according to the procedures in RA3.3.3.1.3
System Name or Identification/Tag
plenum as shown in the figure in Section RA3:3.1.1.
1/4 inch (6 mm) hole equipped with a permanently installed pressure probe, labeled and
❑
PSPP
located downstream of the evaporator coil in the supply plenum as shown in the figure in
Section RA3.3.1.1.
System Name or
Split System
Enter the minimum airflow requirement from the CF -1R (CFM/ton).
Identification/Tag
Calculate the target minimum airflow for the test by multiplying the CFM/ton
System. Location or Area
Garage -
criteria specified on the CF-iR by the nominal cooling capacity of the outdoor.
Served
,
unit (ton).
Confirm that a HSPP or
Target (CFM)
PSPP has been
Enter the diagnostically tested airflow (CFM).
installed on the air
Tested (CFM)
handler per the --
PASS
The system complies if Tested (CFM) is equal or greater than Target (CFM).
requirements of
Enter Pass or Fail
RA3.3.1.1. _„�
Enter, Pass or`Fai
o
E
Cooling Coi
When the Ce
measuring th
Results of• the
verification b
v
Airflow,Verification '
rtificate",of Compliance indicates Cooling Coil Airflow
e cooling coil aicfiow must be performed as specified
:cooling coil airflow- diagnostic test must.be entered
a HERS rater.
verification�is required,.the procedures, forr- -
in Reference Residential Appendix RA3 3'f ,
idithe:tatile below. -This;measure requires !'t p
AG
Select one method from the three choices below for compliance with the Cooling Coil Airflow test requirement for this
dwelling,.
❑ Diagnostic Fan Flow Using Plenum Pressure Matching according to the procedures in RA3.3.3.1.1
❑ Diagnostic Fan Flow Using.Flow Grid Measurement according to the procedures in RA3.3.3.1.2
® Diagnostic Fan Flow Using Flow Capture Hood according to the procedures in RA3.3.3.1.3
System Name or Identification/Tag
Split
System
System Location or Area Served
Split
System
Nominal Cooling Capacity (ton) of the outdoor unit.
S -
Enter the minimum airflow requirement from the CF -1R (CFM/ton).
350 .
Calculate the target minimum airflow for the test by multiplying the CFM/ton
criteria specified on the CF-iR by the nominal cooling capacity of the outdoor.
1750
unit (ton).
Target (CFM)
Enter the diagnostically tested airflow (CFM).
1895
Tested (CFM)
The system complies if Tested (CFM) is equal or greater than Target (CFM).
PASS
Enter Pass or Fail
1
Reg: 212-A0054093A-M2200001A-0000 'Registration Date/Time: 2012/09/28 01:18:33 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance Forms March 2010
INSTALLATION CERTIFICATE CF-6R-MECH-22-HERS
HSPP/PSPP Installation; Cooling Coil Airflow & Fan Watt Draw Test (Page 2 of 2)
Site Address: Enforcement Agency: Permit Number:
54805 Avenida Vallejo, La Quinta CA 92253 -City of La Quint a 11-1194
Fan Watt Draw Verification
When the Certificate of Compliance indicates Fan Watt Draw verification is required, the procedures for measuring the Fan;
Watt Draw must be performed as specified in Reference Residential Appendix RA3.3. Results of the Fan Watt Draw
diagnostic test must be entered in the table below. This measure requires verification by a HERS rater. Note: Fan watt
draw must be measured simultaneously with cooling coil airflow. The fan watt draw measurement and cooling coil airflow
meacurement must cimultanemiciv meet or exceed their taroet criteria specified by the CF -IR for the dwelling.
Select one method from the two choices below for compliance with the Fan Watt Draw. test requirement for this dwelling.
® Portable Watt Meter Measurement according to the procedures in RA3.3.2.2.1
O Utility Revenue Meter Measurement according to the procedures in.RA3.3.2.2.2
System Name or Identification/Tag,.Split
System
Doug Rayburn
CSLB License:
Date Signed: „
System Location or Area Served -
Garage
9/27/2012
Is this installation monitored by a Third Party Quality
Enter the air handler Tested (CFM) from the cooling coil airflow test table •
1895
above.
Enter the fan watt draw requirement from the CF -111 (Watt/CFM).
.58
Calculate the target maximum Watt draw for the test by multiplying the
Watt/CFM criteria specified on the CF -111 by the air handier Tested (CFM).
1099.1
Target (CFM)
Enter the diagnostically tested Watt draw (Watt).
982
Tested (Watt)
The system complies if Tested (Watt) is less than or equal to Target (Watt)
PASS
' - Enter Pass or Fai
-
1
DECLARATION STATEMENT
. I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct.
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized
representative of the person responsible for construction (responsible person).
• I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation)
conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the
enforcement agency. ,.
. I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am
required to take corrective action at my expense. I understand that Energy Commission and HERS provider representatives will also
perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS
rater, and if those Installations fall to meet the requirements of such quality assurance checking, the required corrective action and
additional checking/testing of other installations in that HERS sample group will be performed at my expense.
• I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF -1R that apply to the installation have been met.
• I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the
building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I
understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder
provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data
registry for. multiple orientation alternatives, and beginning October 1, 2010, for all low-rise residential buildings.
Company Name: (Installing Subcontractor or -General Contractor or Builder/Owner)
RAYBURN HEATING AND AIR CONDITIONING -
Responsible Person's Name:
Responsible Person's Signature:
Doug Rayburn
Doug Rayburn
CSLB License:
Date Signed: „
Position With Company (Title):
731939
9/27/2012
Is this installation monitored by a Third Party Quality
Name of TPQCP (if applicable):
Control Program (TPQCP)? . p Yes p No
Reg: 212-A0054093A-M2200001A-0000 Registration Date/Time: 2012/09/28 01:18:33 HERS Provider: CalCERTS, Inc.
2008 Residential Compliance Forms March 2010
a
INSTALLATION CERTIFICATE _ CF-6R-MECH-0
Space Conditioning Systems, Ducts and Fans (Pagel of 2)
Site Address: _
54805 Avenida Vallejo, La Quinta CA 92253 (Split , •
Enforcement Agency:
9 �'
Permit Number:
,
System) +,
City.of La Quinta .
11-1194 ,
.. .`
Space Conditioning Systems,
Heating Eauinment
cooung equipment
Equip
Efficiency
Duct
x
Efficiency
Location
Equip
"'
(AFUE,
(attic,
Type
ARI
# of
etc.)1, 3
crawl-
Heating.
Heating
(package-
CEC Certified Mfr. Name
Reference'.
Identical
(>=CF -1R
space, ;
Duct
Load
Capacity
heat pump)
and Model Number.
Number2
Systems
value)4,
etc.) ,
R -value
(kBtu/hr)
(kBtu/hr)
Split
Guardian
T
�/`f j
Furnace
GGLS10OC20MP11A
2017658
1
.80 AFUE
Other
R-8
100.
80 kBtu
- ^{F
�4 1"
•;•-�,,,.i'
�. v,l]
g
1k
f l I
R l�I`j�,y
• l.n
/ ilt,14
T—�• - 4+ ' �+ .-•'M
.'t�-•'�
�'�A-�Ff
tr4
T7
}
,orf^' jM0
cooung equipment
Equip
1. If project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative
compliance. '+ ,
2. ARI Reference Number can be found by entering the equipment model number at
http://www.aHilirectory.org/ari/ac. php#
3. Listed efficiency on this page must be greater than or equal ( ?) to the value shown on the CF -IR form.
4. When CF -IR is reference it is also applicable to the CF-1R,.CF-IR-AA or CF -IR -ALT
.ALL BOXES MUST BE,CHECKED TO BE A VALID FORMs
`® §110-§113: HVAC equipment icertified by the California Energy Commission. ,
181§150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA,•or ACCA. '
.® §150(i): Setback• Thermostat on all applicable heating and/or cooling systems meet the requirements of
§112(c). - r
N §1500)2: Pipe insulation for,cooling system refrigerant suction, chilled water and brine lines meets
minimum requirements of Table 150,8 and,includes a vapor retardant or is enclosed entirely in
conditioned space.
Reg: 212-A0054093A-M0400001A-0000 Registration Date/Time: 2012/09/28 01:24:29 HERS Provider: CalCERT9, Inc.
2008 Residential Compliance Forms i August 2009. 3
Efficiency
Duct
(SEER
Location
._ Type •
- -c ;.
and EER)
(attic,
(package
ARI
'
# of
1,3
crawl-'
Cooling
Cooling
— heat
CEC Certified Mfr. Name A
Reference
Identical
(>=CF -IR
space,
" Duct
Load
Capacity
pump)
and Model Number
Number2
Systems
value)4
etc.)
R -value
(kBtu/hr)
(kBtu/hr)
Split"
}'Guardianw
'
�/`f j
A/C /
GCGD60S41S3A
5533221~
1
13.5;SEER
Other
R-8
[ 60
5 Tons
- ^{F
�4 1"
•;•-�,,,.i'
�. v,l]
g
1k
f l I
R l�I`j�,y
• l.n
/ ilt,14
T—�• - 4+ ' �+ .-•'M
.'t�-•'�
�'�A-�Ff
tr4
T7
}
,orf^' jM0
1. If project is new construction, see Footnotes to Standards Table 151-B and Table 151-C for duct ceiling alternative
compliance. '+ ,
2. ARI Reference Number can be found by entering the equipment model number at
http://www.aHilirectory.org/ari/ac. php#
3. Listed efficiency on this page must be greater than or equal ( ?) to the value shown on the CF -IR form.
4. When CF -IR is reference it is also applicable to the CF-1R,.CF-IR-AA or CF -IR -ALT
.ALL BOXES MUST BE,CHECKED TO BE A VALID FORMs
`® §110-§113: HVAC equipment icertified by the California Energy Commission. ,
181§150(h): Heating and/or cooling loads calculated in accordance with ASHRAE, SMACNA,•or ACCA. '
.® §150(i): Setback• Thermostat on all applicable heating and/or cooling systems meet the requirements of
§112(c). - r
N §1500)2: Pipe insulation for,cooling system refrigerant suction, chilled water and brine lines meets
minimum requirements of Table 150,8 and,includes a vapor retardant or is enclosed entirely in
conditioned space.
Reg: 212-A0054093A-M0400001A-0000 Registration Date/Time: 2012/09/28 01:24:29 HERS Provider: CalCERT9, Inc.
2008 Residential Compliance Forms i August 2009. 3
Ducts and Fans
§150(m): Duct and Fans y
® 1. All air -distribution system ducts and plenums installed, sealed and insulated'to meet the
requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ,
ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in
conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets
the applicable requirements of UL 181, UL 181A, or UL 1818 or aerosol sealant that meets the
requirements of UL 723. If mastic or tape is used to seal openings greater than ,1/4. inch, the combination
of mastic and either mesh or tape shall,be used; and
® 1. Building cavities; support platforms for air handlers, and plenums defined or constructed with
materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying.
conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities.
and support platforms shall not be compressed to cause reductions in the cross-sectional area of the
ducts.
{
® 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back
rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. `
® 7. Exhaust fan systems have back draft or automatic dampers. `
® 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible,
manually operated dampers. - -
® Protection of Insulation. Insulation, shall be protected from damage,'including that due to sunlight,
moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or
'painted with a coating that is water retardant and provides shielding from solar radiation that can cause
degradation of the material:
010. Flexiblerd_ucts cannot have', porous=inner, cores. •.�jrjr{
DECLARATION STATEMENT ,
. I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. '
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized
representative of the person responsible for construction (responsible person).
. I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation)
conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the
enforcement agency.
• I reviewed a copy of the Certificate of Compliance (CF -SR) form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met.
• I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the
building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I
understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder
provides to the building owner at occuoancv.
INSTALLATION CERTIFICATE CF-6R-MECH-0
t y �
Space Conditioning Systems, Ducts and Fans (Page 2 of 2)
Site Address:
54805 Avenida Vallejo, La,Quinta CA 92253 (Split
Enforcement Agency:.
Permit Number:
Doug Rayburn. _
System)
City of La Quinta
11-1194
CSLB License:
731939
Ducts and Fans
§150(m): Duct and Fans y
® 1. All air -distribution system ducts and plenums installed, sealed and insulated'to meet the
requirements of CMC Sections 601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ,
ducts and plenums are insulated to a minimum installed level of R-4.2 or enclosed entirely in
conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets
the applicable requirements of UL 181, UL 181A, or UL 1818 or aerosol sealant that meets the
requirements of UL 723. If mastic or tape is used to seal openings greater than ,1/4. inch, the combination
of mastic and either mesh or tape shall,be used; and
® 1. Building cavities; support platforms for air handlers, and plenums defined or constructed with
materials other than sealed sheet metal, duct board or flexible duct shall not be used for conveying.
conditioned air. Building cavities and support platforms may contain ducts. Ducts installed in cavities.
and support platforms shall not be compressed to cause reductions in the cross-sectional area of the
ducts.
{
® 2D. Joints and seams of duct systems and their components shall not be sealed with cloth back
rubber adhesive duct tapes unless such tape is used in combination with mastic and draw bands. `
® 7. Exhaust fan systems have back draft or automatic dampers. `
® 8. Gravity ventilating systems serving conditioned space have either automatic or readily accessible,
manually operated dampers. - -
® Protection of Insulation. Insulation, shall be protected from damage,'including that due to sunlight,
moisture, equipment maintenance, and wind. Cellular foam insulation shall be protected as above or
'painted with a coating that is water retardant and provides shielding from solar radiation that can cause
degradation of the material:
010. Flexiblerd_ucts cannot have', porous=inner, cores. •.�jrjr{
DECLARATION STATEMENT ,
. I certify under penalty of perjury, under the laws of the State of California, the information provided on this form is true and correct. '
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized
representative of the person responsible for construction (responsible person).
. I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation)
conforms to all applicable codes and regulations, and the installation is consistent with the plans and specifications approved by the
enforcement agency.
• I reviewed a copy of the Certificate of Compliance (CF -SR) form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met.
• I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the
building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I
understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder
provides to the building owner at occuoancv.
Reg:,212-A0054093A-M0400001A-0000 Registration Date/Time: 2012/09/28 01:24:29 HERS Provider: Ca10ERTS, Inc.
2008'Residential Compliance Forms - August 2009
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner) .
t y �
RAYBURN HEATING AND AIR CONDITIONING
Responsible Person's Name:
Responsible Person's Signature:
Doug Rayburn. _
boug Rayburn
CSLB License:
731939
Date Signed:
9/27/2012'
Position With Company (Title):
Reg:,212-A0054093A-M0400001A-0000 Registration Date/Time: 2012/09/28 01:24:29 HERS Provider: Ca10ERTS, Inc.
2008'Residential Compliance Forms - August 2009
t y �
Reg:,212-A0054093A-M0400001A-0000 Registration Date/Time: 2012/09/28 01:24:29 HERS Provider: Ca10ERTS, Inc.
2008'Residential Compliance Forms - August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS
Duct Leakage Test - Completely New or Replacement Duct System (Page 1 of 2)
Site Address:.~
54805 Avenida Vallejo, La Quinta CA 92253 (Split
'
Enforcement Agency:
Permit Number: .
System) ' . .
Pty of La Quinta
11=1194
Enter the Duct System Name or Identification/Tag: Split System -
Enter the Duct System Location or Area Served: Garage' -
Note: Submit one,instal/ation Certificate'for each duct system that,must demonstrate compliance in the
dwelling. • _ • _
Duct Leakage Diagnostic Test - completely new or replacement duct system +
Enter a value for the Allowed Leakage (CFM) for the dud system leakage verification. The value entered must be the
VLLDCS criteria or one of the three calculated leakage rates described below. '
Verified Low Leakage Ducts in Conditioned Space (VLLDCS) Compliance Credit. If compliance
credit for verified low leakage duds in conditioned space is shown in the special features section of the
Allowed
CF -1R, the leakage to outside test method must be used to verify duct leakage (refer to RA3.1.4.3.4),
Leakage
and 25 CFM must be entered for Allowed Leakage. i
'(CFM)
Allowed leakage calculation - (select one calculation, method from this section). Use 6% (leakage
factor = 0.06) for calculations if tested at "final" or 4%. (leakage factor = 0.04) if tested at "rough."
When utilizing Low Leakage Air Handier (LLAH) credit, the allowed duct leakage may be specified by the
CF -1R to be less than 6%, in which case the user-specified leakage rate must be used in the
calculations below. For example, if the user-specified leakage (specified as a percentage of fan airflow)
use aleakage,factor of 0.03 in.the calculations,below.'
is reported on the�CF-iR as 3%, theEns
® Cooling system method:Nominal�rcapacity
of condenser in T,/ x 400 x leakage factor - m CFM
`
t
p Heating system method:,r, � � 4 � �. lfactoAl
21.7 x +� ,Output Capacity;in Thousands.of Btu/hr x leakage CFM. "J
r.
..1 ,.a•`+•r `�... 'er- 'L. w -:•r �•'•-. r �.. ;�..-r"4.,�� i �....-,. .i -. -
'lam'
C3 Measured airflow method (RA3.3)3 ~
�y` "
Enter measured fan flow in CFM here x leakage factor = CFM
Enter value for Actual leakage (CFM),in the right column, from measurement using applicable dud
Actual
leakage pressurization test procedure from Reference Residential Appendix RA3.1(CFM @ 25 Pa).
Leakage
(CFM)
List Actual Leakage from duct leakage test(CFM)
114
Pass if Actual Leakage is'equal to or,less than Allowed Leakage ®Pass O Fail
For complete, replacement of duct systems only, if the 6 percent leakage rate criteria cannot be met, a
smoke test should be performed to verify that the excess leakage is coming only from a pre-existing
furnace cabinet (air handler cabinet), and not from other accessible portions of the duct system. A HERS
rater must verify the installation (No sampling allowed).
List Actual Leakage from smoke test(CFM)
Pass if all accessible leaks (except for existing air handler) are sealed -using smoke � Pass D Fail
Reg: 212-A0054093A-M2000001A-0000 Registration Date/Time: 2012/09/28 01:17:27 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance,Forms August 2009
r
•r
Reg: 212-A0054093A-M2000001A-0000 Registration Date/Time: 2012/09/28 01:17:27 HERS Provider: Ca10ERTS, Inc.
2008 Residential Compliance,Forms August 2009
INSTALLATION CERTIFICATE CF-6R-MECH-20-HERS
Duct Leakage Test — Completely. New or Replacement Duct System
(Page 2 of 2)
Site Address: , - •.
54805 Avenida Vallejo, La Quirita CA 92253 (Split
Enforcement Agency:
Permit Number:
System)
City of La Quinta
,
11-1194
.
Compliance Method
This dwelling was: (select one of the following two choices):
® Tested at Final' -
❑ Tested at Rough -in (requires'installer to complete the visual inspection at final construction stage described below) •
Visual Inspection at Final Construction Stage (if applicable)
After installing the interior finishing wall and verifying that the above rough -in tests was completed, the following
procedure must be performed:
❑ For all supply and return registers, verify that the spaces between the register boot and the interior finishing wall are
properly sealed. -
❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points
between the air handler and the supply and return plenums to verify that the connection points are properly sealed.
❑ Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used.
® Outside air (OA) ducts for`Central•Fan Integrated (CFI) ventilation systems, shall not be sealed/taped off
during duct leakage testing. CFI OA ducts that utilize controlled motorized dampers, that open only when OA
ventilation is required to meet ASHRAE Standard 62.2, and close when OA ventilation is not required, may
be configured to the closed position during duct leakage testing.
® All supply and"return register boots must be sealed to the drywall
® New ductInstallations cannot-tutilizefbuilding cavities asiplenums or platformireturns fn lieu of ducts.
® Mastic and`draw bands"must be used in combination with Cloth backed, rubber adhesive•duct tape to seal
leaks at duct connections�_?f'
I
DECLARATION STATEMENT
• I certify under penalty of perjury, under the laws of the State of California, the Information provided on this form is true and correct.
• I am eligible under Division 3 of the Business and Professions Code to accept responsibility for construction, or an authorized
representative of the. person responsible for construction (responsible person). _
• I certify that the installed features, materials, components, or manufactured devices identified on this certificate (the installation)
conforms to all applicable codes and regulations, and the Installation is consistent with the plans and specifications approved by the
enforcement agency.
« • I understand that a HERS rater will check the installation to verify compliance, and that that if such checking identifies defects, I am
required to take corrective action at my expense. I, understand that Energy Commission and HERS provider representatives will also
perform quality assurance checking of installations, including those approved as part of a sample group but not checked by a HERS
rater, and if those Installations fail to meet the requirements of such quality assurance checking, the required corrective action and .
additional checking/testing of other installations in that HERS sample group will be performed at my expense.
• I reviewed a copy of the Certificate of Compliance (CF -1R) form approved by the enforcement agency that identifies the specific
requirements for the installation. I certify that the requirements detailed on the CF -111 that apply to the installation have been met.
• I will ensure that a completed, signed copy of this Installation Certificate shall be posted, or made available with the "
building permit(s) issued for the building, and made available to the enforcement agency for all applicable inspections. I
understand that a signed copy of this Installation Certificate is required to be included with the documentation the builder.
provides to the building owner at occupancy. I will ensure that all Installation Certificates will come from a HERS provider data
registry for multiple orientation altematives, and beginning October 1, 2010, for all low-rise residential buildinas. .
Company Name: (Installing Subcontractor or General Contractor or Builder/Owner)
RAYBURN HEATING AND AIR CONDITIONING
Responsible Person's Name: r
Responsible Person's Signature:
Doug Rayburn
boug Rayburn
CSLB License: _
Date Signed:
position With Company (Title): .
731939
9/27/2012
Is this installation monitored by a Third Party Quality
Name of TPQCP (if applicable):
Control Program (TPQCP)? [3 Yes ❑ No,
C
• Reg: 212-A0054093A-M2000001A-0000 Registration Date/Time:,2012/09/28 01:17:27 HERS Provider: Ca10ERTS,'Inc.
2008 Residential Compliance Forms August 2009
BUILDING ENERGY ANALYSIS REPORT
PROJECT:
EI Rancho Homes Inc.
Avenue Vallejo
La Quinta, CA
Project Designer:
RIECEIV E1E)
FEB 0 1 2012
Report Prepare y:
Joan D. Hacker
Insu-form, Inc.
77-810 Las Montanas Road, Suite 201
Palm Desert, Ca 92211
760-345-1352
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
.Job Number:
DATE BY-_
Date:
1/25/2012
The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is
authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards.
This program developed by EnergySoft, LLC — www.energysoft.com.
EnergyPro 5.1 by EnergySoft User Number: 2655 RunCode: 2012-01-25711:04:27 ID:
1
i
i
BUILDING ENERGY ANALYSIS REPORT
PROJECT:
EI Rancho Homes Inc.
Avenue Vallejo
La Quinta, CA
Project Designer:
RIECEIV E1E)
FEB 0 1 2012
Report Prepare y:
Joan D. Hacker
Insu-form, Inc.
77-810 Las Montanas Road, Suite 201
Palm Desert, Ca 92211
760-345-1352
CITY OF LA QUINTA
BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
.Job Number:
DATE BY-_
Date:
1/25/2012
The EnergyPro computer program has been used to perform the calculations summarized in this compliance report. This program has approval and is
authorized by the California Energy Commission for use with both the Residential and Nonresidential 2008 Building Energy Efficiency Standards.
This program developed by EnergySoft, LLC — www.energysoft.com.
EnergyPro 5.1 by EnergySoft User Number: 2655 RunCode: 2012-01-25711:04:27 ID:
1
TABLE OF CONTENTS
Cover Page 1
Table of Contents 2
Form CF -1 R Certificate of Compliance 3
Form MF -1 R Mandatory Measures Summary .9
HVAC System Heating and Cooling Loads Summary 12
EnergyPro 5.1 by EnergySoft Job Number: ID: User Number: 2655
PERFORMANCE CERTIFICATE: Residential Part 1 of 5
CF -1 R
Project Name
El Rancho Homes Inc.
Building Type m Single Family ❑ Addition Alone
❑ Multi Family ❑ Existing+ Addition/Alteration
Date
1/25/2012
Project Address
Avenue Vallejo La Quinta
California Energy Climate Zone
CA Climate Zone 15
Total Cond. Floor Area
1,972
Addition
n/a
# of Stories
1
FIELD INSPECTION ENERGY CHECKLIST
❑ Yes ❑ No HERS Measures -- If Yes, A CF -4R must be provided per Part 2 of 5 of this form.
❑ Yes ❑ No Special Features -- If Yes, see Part 2 of 5 of this form for details.
INSULATION
Construction Type
Area Special
Cavity Features see Part 2 of 5 Status
Wall Wood Framed
R-13 1,094 New
Door Opaque Door
None 20 New
Roof Wood Framed Attic
R-38 1,972 Radiant Barrier New
Slab Unheated Slab -on -Grade
None 1,972 Perim = 51' New
FENESTRATION U-
Orientation Area Factor
Exterior
SHGC Overhang Sidefins Shades Status
Front (E) 6.0 0.310
0.27 4.0 none Bug Screen New
Front (E) 33.4 0.310
0.29 none none Bug Screen New
Front (E) 28.8 0.310
0.27 none none Bug Screen New
Left (S) 58.0 0.310
0.27 none none Bug Screen New
Left (S) 40.0 0.310
0.29 none none Bug Screen New
Rear (lM 40.0 0.310
0.29 none none Bug Screen New
Rear (W) 30.0 0.310
0.27 none none Bug Screen New
Right (N) 66.0 0.310
0.27 none none Bug Screen New
HVAC SYSTEMS
Ot . Heating Min. Eff Cooling Min. Eff Thermostat Status
1 Central Furnace 80% AFUE Split Air Conditioner 13.0 SEER Setback
New
HVAC DISTRIBUTION
Location Heating
Duct
Cooling Duct Location R -Value Status
Whole House Ducted
Ducted Attic, Ceiling Ins, vented 8.0 New
r
WATER HEATING
Qty. Type Gallons Min. Eff Distribution Status
1 Small Gas 50
0.62 All Pipes Ins New
Ener Pro 5.1 by Ener Soft User Number: 2655 RunCode: 2012-01-25T11:04:27 ID:
Page 3 of 12
PERFORMANCE CERTIFICATE: Residential Part 2 of 5 CF -1 R
Project Name
EI Rancho Homes Inc.
Building Type ® Single Family ❑ Addition Alone
1 ❑ Multi Family ❑ Existing+ Addition/Alteration
Date
1/25/2012
SPECIAL FEATURES INSPECTION CHECKLIST
The enforcement agency should pay special attention to the items specified in this checklist. These items require special written
justification and documentation, and special verification to be used with the performance approach. The enforcement agency.
determines the adequacy of the justification, and may reject a building or design that otherwise complies based on the adequacy of
the special justification and documentation submitted.
HIGH MASS Design - Verify Thermal Mass: 1,072.0 ftz Exposed Slab Floor, 3.500" thick at Whole Houser
HIGH MASS Design - Verify Thermal Mass: 900.0 ft2 Covered Slab Floor, 3.500" thick at Whole Houser
The Roof R-38 Roof Attic includes credit for a Radiant Barrier that is Continuous meeting eligibility and installation criteria as specified in Residential
Appendix RA4.2.2.
HERS REQUIRED VERIFICATION
Items in this section require field testing and/or verification by a certified HERS Rater. The inspector must receive a
completed CF -4R form for each of the measures listed below for final to be given.
The Cooling System York GCGD 60S 415 3A includes credit for a 11.9 EER Condenser. A certified HERS rater must field verify the installation of the
correct Condenser.
The HVAC System Whole House incorporates HERS Verified Refrigerant Charge or a Charge Indicator Display.
The HVAC System Whole House incorporates HERS verified Duct Leakage. HERS field verification and diagnostic testing is required to verify that
duct leakage meets the specified criteria.
Ener Pro 5.1 by Ene Soft User Number: 2655 RunCode: 2012-01-25T11:04:27 ID: Page 4 of 12
PERFORMANCE CERTIFICATE: Residential Part 3 of 5 CF-1 R
Project Name
Building Type m Single Family ❑ Addition Alone
Date
EI Rancho Homes Inc.
1 ❑ Multi Family ❑ Existing+ Addition/Alteration
1/25/2012
ANNUAL ENERGY USE SUMMARY
Standard Proposed Margin
TDV kBtu/ft2 r
Space Heating 2.12 1.62 0.50
Space Cooling 45.76 44.46 1.30
Fans 9.28 12.32 -3.04
Domestic Hot Water 16.48 14.94 1.54
Pumps 0.00 0.00 0.00
Totals 73.65 73.35 0.30
Percent Better Than Standard: 0.4%
BUILDING COMPLIES - HERS VERIFICATION REQUIRED
Fenestration
Building Front Orientation: (E) 90 deg Ext. Walls/Roof Wall Area Area
Number of Dwelling Units: 1.00 (E) 400 68
Fuel Available at Site: Natural Gas (S) 300 98
Raised Floor Area: 0 (w) 416 70
Slab on Grade Area: 1,972 (N) 300 66
Average Ceiling Height: 9.0 Roof 1,972 0
Fenestration Average U-Factor: 0.31 TOTAL: 302
Average SHGC: 0.28 Fenestration/CFA Ratio: 15.3%
REMARKS
STATEMENT OF COMPLIANCE
This certificate of compliance lists the building features and specifications needed
to comply with Title 24, Parts 1 the Administrative Regulations and Part 6 the
Efficiency Standards of the California Code of Regulations.
The documentation author hereby certifies that the documentation is accurate and complete.
Documentation Author
Company Insu-form, Inc.
Address 77-810 Las Montanas Road, Suite 201 Name Joan D. Hacker A20&
City/State/ZipCity/State/Zip Palm Desert, Ca 92211 Phone 760-345-1352 Si ed Date
The individual with overall design responsibility hereby certifies that the proposed building design represented in this set
of construction documents is consistent with the other compliance forms and worksheets, with the specifications, and
with any other calculations submitted with this permit application, and recognizes that compliance using duct design,
duct sealing, verification of refrigerant charge, insulation installation quality, and building envelope sealing require
installer testing and certification and field verification by an approved HERS rater.
Design r or Owner (per Business & Professions Code)
Company1�� `j'Te91DtC3 /ISG.
t6tr r
Address P0. � 4 Name`760- ' (
ignDate e
City/State/Zip Phone (5�4::q7�2
-
Ene Pro 5.1 by Ener Soft User Number.' 2655 RunCode: 2012-01-25711:04:27 /D: Page 5 of 12
CERTIFICATE OF COMPLIANCE: Residential
Part 4 of 5) - CF -1 R
Project Name
EI Rancho Homes Inc.
Building Type m Single Family ❑ Addition Alone
❑ Multi Family ❑ Existing+ Addition/Alteration
Date
1112512012
OPAQUE SURFACE DETAILS
Surface
Type Area
U- Insulation Joint Appendix
Factor Cavi Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments
Wall
312
0.102 R-13
90
90 New 4.3.1-A3
Whole House
Door
20
0.500 None
90
90 New 4.5.1-A4
Whole House
Wall
202
0.102 R-13
180
90 New 4.3.1-A3
Whole House
Wall
346
0.102 R-13
270
90 New 4.3.1-A3
Whole House
Wall
234
0.102 R-13
0
90 New 4.3.1-A3
Whole House
Roof
1,972
0.025 R-38
90
0 New 4.2.1-A21
Whole House
Slab
1,072
0.730 None
0
180 New 4.4.7-A1
Whole House
Slab
900
0.730 None
0
180 New 4.4.7-A1
Whole House
FENESTRATION SURFACE DETAILS
ID
Type
Area LI -Factor'
SHGC
Azm Status
Glazing Type
Location/Comments
1
Window
6.0 0.310 NFRC
0.27 NFRC 90 New
IWC 6200 AlumA-ow-E
Whole House
2
Window
33.4 0.310 NFRC
0.29 NFRC 90 New
Dual Pane Windows
Whole House
3
Window
2.7 0.310 NFRC
0.27 NFRC 90 New
IWC 6200 Alum/Low-E
Whole House
4
Window
2.7 0.310 NFRC
0.27 NFRC 90 New
IWC 6200 Alum/Low-E
Whole House
5
Window
6.7 0.310 NFRC
0.27 NFRC 90 New
IWC 6200 Alum/Low-E
Whole House
6
Window
6.7 0.310 NFRC
0.27 NFRC 90 New
IWC 6200 AlumA-ow-E
Whole House
7
Window
10.0 0.310 NFRC
0.27 NFRC 90 New
IWC 6200 Alum/Low-E
Whole House
8
Window
9.0 0.310 NFRC
0.27 NFRC 180 New
IWC 6200 AlumA-ow-E
Whole House
9
Window
9.0 0.310 NFRC
0.27 NFRC 180 New
IWC 6200 AlumA-ow-E
Whole House
10
Window
40.0 0.310 NFRC
0.29 NFRC 180 New
Dual Pane Windows
Whole House
11
Window
12.0 0.310 NFRC
0.27 NFRC 180 New
IWC 6200 Alum/Low-E
Whole House
12
Window
20.0 0.310 NFRC
0.27 NFRC 180 New
IWC 6200 AlumA-ow-E
Whole House
13
Window
8.0 0.310 NFRC
0.27 NFRC 180 New
IWC 6200 AlumA-ow-E
Whole House
14
Window
40.0 0.310 NFRC
0.29 NFRC 270 New
Dual Pane Windows
Whole House
15
Window
12.0 0.310 NFRC
0.27 NFRC 270 New
IWC 6200 Alumkow-E
Whole House
16
Window
4.0 0.310 NFRC
0.27 NFRC 270 New
I IWC 6200 Alum/Low-E
Whole House
(1) LI -Factor Type: 116-A = Default Table from Standards, NFRC = Labeled Value
2 SHGC Type: 116-B = Default Table from Standards, NFRC = Labeled Value
EXTERIOR SHADING DETAILS
ID
Exterior Shade Type SHGC
Window
Hot Wd
Ove hanq Left Fin Ri ht Fin
Len I Hat I LExt RExt Dist Len Hat Dist Len Hat
1
Bug Screen
0.76
2.01 3.0 4.01 0.1 4.0 4.0
2
Bug Screen
0.76
3
Bug Screen
0.76
4
Bug Screen
0.76
5
Bug Screen
0.76
6
Bug Screen
0.76
7
Bug Screen
0.76
8
Bug Screen
0.76
9
Bug Screen
0.76
10
Bug Screen
0.76
11
Bug Screen
0.76
12
Bug Screen
0.76
13
Bug Screen
0.76
14
Bug Screen
0.76
15
JBug Screen
1 0.76
16
JBug Screen
1 0.76
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CERTIFICATE OF COMPLIANCE: Residential Part 4 of 5 CF -1 R
Project Name
EI Rancho Homes Inc.
Building Type m Single Family ❑ Addition Alone
❑ Multi Family ❑ Existing+ Addition/Alteration
Date
1112512012
OPAQUE SURFACE DETAILS
Surface U- Insulation Joint Appendix
Type Area Factor Cavit Exterior Frame Interior Frame Azm Tilt Status 4 Location/Comments
FENESTRATION SURFACE DETAILS
ID Tvpe Area
LI -Factor' SHGCz
Azm Status Glazing Type Location/Comments
17 Window 4.0
0.310 NFRC 0.27 NFRC 270 New IWC 6200 Alum/Low-E Mole House
18 Window 4.0
0.310 NFRC 0.27 NFRC 270 New IWC 6200 Alum/Low-E Mole House
19 Window 6.0
0.310 NFRC 0.27 NFRC 270 New IWC 6200 Alum/Low-E Mole House
20 Window 4.0
0.310 NFRC 0.27 NFRC 0 New IWC 6200 Alum/Low-E Whole House
21 Window 25.0
0.310 NFRC 0.27 NFRC 0 New IWC 6200 Alum/Low-E Whole House
22 Window 8.0
0.310 NFRC 0.27 NFRC 0 New IWC 6200 Alum/Low-E Whole House
23 Window 25.0
0.310 NFRC 0.27 NFRC 0 New IWC 6200 Alum/Low-E WNhole House
24 Window 4.0
0.310 NFRC 0.27 NFRC 0 New IWC 6200 Alum/Low-E WNhole House
(1) LI -Factor Type:
2 SHGC Type:
116-A = Default Table from Standards, NFRC = Labeled Value
116-B = Default Table from Standards, NFRC = Labeled Value
EXTERIOR SHADING DETAILS
ID Exterior Shade Type
Window
SHGC Hat Wd
Ove hang Left Fin Right Fin
Len H t LExt RExt Dist Len H t Dist Len H t
17 Bug Screen
0.76
18 Bug Screen
0.76
19 Bug Screen
0.76
20 Bug Screen
0.76
21 Bug Screen
0.76
22 Bug Screen
0.76
23 Bug Screen
0.76
24 Bug Screen
0.76
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CERTIFICATE OF COMPLIANCE: Residential Part 5 of 5
CF-1 R
Project Name
E/ Rancho Homes Inc.
Building Type ❑ Single Family ❑ Addition Alone
❑ Multi Family ❑ Existing+ Addition/Alteration
Date
1112512012
BUILDING ZONE INFORMATION
System Name Zone Name
Floor Area ft
New Existing Altered Removed Volume
Year Built
Whole House Whole Houser
1,972
17,748
Totals 1 1,9721 01 01 0
HVAC SYSTEMS
System Name Ot . Heating Type
Min. Eff. Cooling Type Min. Eff. Thermostat Ty e
Status
Whole House 1 Central Furnace
80% AFUE Split Air Conditioner 13.0 SEER Setback
New
HVAC DISTRIBUTION
System Name Heating
Duct
Coolin Duct Location R-Value
Ducts
Tested? Status
Whole House Ducted Ducted Attic, Ceiling Ins, vented 8.0
m
New
WATER HEATING SYSTEMS
S stem Name
Ot .
Type
Distribution
Rated
Input
Btuh
Tank
Cap.
al
Energy
Factor
or RE
Standby
Loss or
Pilot
Ext.
Tank
Insul. R-
Value
Status
A. 0. SMITH FPS-50-224
1
Small Gas
All Pipes Ins
43,000
50
0.62
n/a
n/a
New
MULTI-FAMILY WATER
HEATING
DETAILS
HYDRONIC
HEATING
SYSTEM
PIPING
Control
Hot Water Piping Length
(ft)o
.ca
v
a S
System Name
Pipe
Len th
Pipe
Diameter
Insul.
Thick.
Ot .
HP
Plenum Outside Buried
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MANDATORY MEASURES SUMMARY: Residential Pae 1 of 3 MF -1 R
Project Name
EI Rancho Homes Inc.
Date
1 1/25/2012
NOTE: Low-rise residential buildings subject to the Standards must comply with all applicable mandatory measures listed, regardless of
the compliance approach used. More stringent energy measures listed on the Certificate of Compliance (CF -1 R, CF -1 R -ADD, or CF -
1 R -ALT Form) shall supersede the items marked with an asterisk (*) below. This Mandatory Measures Summary shall be incorporated
into the permit documents, and the applicable features shall be considered by all parties as minimum component performance
specifications whether they are shown elsewhere in the documents or in this summary. Submit all applicable sections of the MF -1 R
Form with plans.
Building Envelope Measures:
116(a)l: Doors and windows between conditioned and unconditioned spaces are manufactured to limit air leakage.
§116(a)4: Fenestration products (except field -fabricated windows) have a label listing the certified LI -Factor, certified Solar Heat Gain
Coefficient SHGC and infiltration that meets the requirements of 10-111 (a).
117: Exterior doors and windows are weather-stripped; all joints and penetrations are caulked and sealed.
118(a): Insulationspecified or installed meets Standards for Insulating Material. Indicate type and include on CF -6R Form.
§118(1): The thermal emittance and solar reflectance values of the cool roofing material meets the requirements of §118(1) when the
installation of a Cool Roof is specified on the CF -1 R Form.
*§1 50 a : Minimum R-19 insulation in wood -frame ceiling orequivalent Ll -factor.
§150(b): Loose fill insulation shall conform with manufacturer's installed design labeled R -Value.
*§15 (c): Minimum R-13 insulation in wood -frame wall orequivalent Ll -factor.
*§150(d): Minimum R-13 insulation in raised wood -frame floor orequivalent Ll -factor.
§150(f): Air retarding wrap is tested labeled and installed according to ASTM E1677-95(2000) when specified on the CF -1 R Form.
§150(g): Mandatory Vapor barrier installed in Climate Zones 14 or 16.
§150(1): Water absorption rate for slab edge insulation material alone without facings is no greater than 0.3%; water vapor permeance
rate is no greater than 2.0perm/inch and shall be protected from physical damage and UV light deterioration.
Fireplaces, Decorative Gas Appliances and Gas Log Measures:
150 e 1 A: Masonry or factory -built fireplaces have a closable metal or glass door covering the entire opening of the firebox.
§150(e)1 B: Masonry or factory -built fireplaces have a combustion outside air intake, which is at least six square inches in area and is
equipped with a with a readily accessible, operable, and tight -fitting damper and or a combustion -air control device.
§150(e)2: Continuous burning pilot lights and the use of indoor air for cooling a firebox jacket, when that indoor air is vented to the
outside of the building, are prohibited.
Space Conditioning, Water Heating and Plumbing System Measures:
§110-§113: HVAC equipment, water heaters, showerheads, faucets and all other regulated appliances are certified by the Energy
Commission.
§113(c)5: Water heating recirculation loops serving multiple dwelling units and High -Rise residential occupancies meet the air release
valve, backflow prevention, pump isolation valve, and recirculation loop connection requirements of §113(c)5.
§115: Continuously burning pilot lights are prohibited for natural gas: fan -type central furnaces, household cooking appliances
(appliances with an electrical supply voltage connection with pilot lights that consume less than 150 Btu/hr are exempt), and pool and
spa heaters.
150(h): Heating and/or cooling loads are calculated in accordance with ASHRAE, SMACNA or ACCA.
150(i): Heating systems are equipped with thermostats that meet the setback requirements of Section 112(c).
§150(j)1A: Storage gas water heaters rated with an Energy Factor no greater than the federal minimal standard are externally wrapped
with insulation having an installed thermal resistance of R-12 or greater.
§1500)113: Unfired storage tanks, such as storage tanks or backup tanks for solar water -heating system, or other indirect hot water
tanks have R-12 external insulation or R-16 internal insulation where the internal insulation R -value is indicated on the exterior of the
tank.
§150(j)2: First 5 feet of hot and cold water pipes closest to water heater tank, non -recirculating systems, and entire length of
recirculatina sections of hot water pipes are insulated per Standards Table 150-13.
§1500)2: Cooling system piping (suction, chilled water, or brine lines),and piping insulated between heating source and indirect hot
water tank shall be insulated to Table 150-B and Equation 150-A.
§1500)2: Pipe insulation for steam hydronic heating systems or hot water systems >15 psi, meets the requirements of Standards Table
123-A.
§150(4)3A: Insulation is protected from damage, including that due to sunlight, moisture equipment maintenance and wind.
§150(j)3A: Insulation for chilled water piping and refrigerant suction lines includes a vapor retardant or is enclosed entirely in
conditioned space.
150(j)4: Solar water -heating systems and/or collectors are certified by the Solar Rating and Certification Corporation.
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MANDATORY MEASURES SUMMARY: Residential (Page 2 of 3 MF -1 R
Project Name
Date
EI Rancho Homes Inc.
1/25/2012
§150(m)l : All air -distribution system ducts and plenums installed, are sealed and insulated to meet the requirements of CMC Sections
601, 602, 603, 604, 605 and Standard 6-5; supply -air and return -air ducts and plenums are insulated to a minimum installed level of R-
4.2 or enclosed entirely in conditioned space. Openings shall be sealed with mastic, tape or other duct -closure system that meets the
applicable requirements of UL 181, UL 181 A, or UL 181 B or aerosol sealant that meets the requirements of UL 723. If mastic or tape is
used to seal openings reater than 1/4 inch the combination of mastic and either mesh or tape shall be used
§150(m)1: Building cavities, support platforms for air handlers, and plenums defined or constructed with materials other than sealed
sheet metal, duct board or flexible duct shall not be used for conveying conditioned air. Building cavities and support platforms may
contain ducts. Ducts installed in cavities and support platforms shall not be compressed to cause reductions in the cross-sectional area
of the ducts.
§150(m)2D: Joints and seams of duct systems and their components shall not be sealed with cloth back rubber adhesive duct tapes
unless such tae is used in combination with mastic and draw bands.
150(m)7: Exhaust fans stems have back draft or automatic dampers.
§150(m)8: Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated
dampers.
§150(m)9: Insulation shall be protected from damage, including that due to sunlight, moisture, equipment maintenance, and wind.
Cellular foam insulation shall be protected as above or painted with a coating that is water retardant and provides shielding from solar
radiation that can cause degradation of the material.
150 m 10: Flexible ducts cannot have porous inner cores.
§150(o): All dwelling units shall meet the requirements of ANSI/ASHRAE Standard 62.2-2007 Ventilation and Acceptable Indoor Air
Quality in Low -Rise Residential Buildings. Window operation is not a permissible method of providing the Whole Building Ventilation
required in Section 4 of that Standard.
Pool and Spa Heating Systems and Equipment Measures:
§114(a): Any pool or spa heating system shall be certified to have: a thermal efficiency that complies with the Appliance Efficiency
Regulations; an on-off switch mounted outside of the heater; a permanent weatherproof plate or card with operating instructions; and
shall not use electric resistance heating ora pilot light.
§114(b)1: Any pool or spa heating equipment shall be installed with at least 36" of pipe between filter and heater, or dedicated suction
and return lines, or built-up connections for future solar heating.
114(b)2: Outdoor pools ors as that have a heat pump or gas heater shall have a cover.
§114(b)3: Pools shall have directional inlets that adequately mix the pool water, and a time switch that will allow all pumps to be set or
programmed to run only during off-peak electric demand periods.
150 : Residential pool systems orequipment meet the pump sizing, flow rate, piping, filters, and valve requirements of §150
Residential Lighting Measures:
§150(k)1: High efficacy luminaires or LED Light Engine with Integral Heat Sink has an efficacy that is no lower than the efficacies
contained in Table 150-C and is not a low efficacy luminaire asspecified by §150 k 2.
150(k)3: The wattage of permanently installed luminaires shall be determined asspecified by §130(d).
§150(k)4: Ballasts for fluorescent lamps rated 13 Watts or greater shall be electronic and shall have an output frequency no less than
20 kHz.
§150(k)5: Permanently installed night lights and night lights integral to a permanently installed luminaire or exhaust fan shall contain
only high efficacy lamps meeting the minimum efficacies contained in Table 150-C and shall not contain a line -voltage socket or line -
voltage lamp holder; OR shall be rated to consume no more than five watts of power as determined by §130(d), and shall not contain a
medium screw -base socket.
150(k)6: Lighting integral to exhaust fans, in rooms other than kitchens, shall meet the applicable requirements of §150(k).
150(k)7: All switching devices and controls shall meet the requirements of §150(k)7.
§150(k)8: A minimum of 50 percent of the total rated wattage of permanently installed lighting in kitchens shall be high efficacy.
EXCEPTION: Up to 50 watts for dwelling units less than or equal to 2,500 ft2 or 100 watts for dwelling units larger than 2,500 ft2 may be
exempt from the 50% high efficacy requirement when: all low efficacy luminaires in the kitchen are controlled by a manual on occupant
sensor, dimmer, energy management system (EMCS), or a multi -scene programmable control system; and all permanently installed
luminaries in garages, laundry rooms, closets greater than 70 square feet, and utility rooms are high efficacy and controlled by a
manual -on occupant sensor.
§150(k)9: Permanently installed lighting that is internal to cabinets shall use no more than 20 watts of power per linear foot of
illuminated cabinet.
EnergyPro 5.1 by EnergySoft User Number: 2655 RunCode: 2012-01-25711:04:27 /D: Page 10 of 12
MANDATORY MEASURES SUMMARY: Residential (Page 3 of 3 MF -1 R
Project Name
Date
EI Rancho Homes Inc.
1/25/2012
§150(k)10: Permanently installed luminaires in bathrooms, attached and detached garages, laundry rooms, closets and utility rooms
shall be high efficacy.
EXCEPTION 1: Permanently installed low efficacy luminaires shall be allowed provided that they are controlled by a manual -on
occupant sensor certified to comply with the applicable requirements of §119.
EXCEPTION 2: Permanently installed low efficacy luminaires in closets less than 70 square feet are not required to be controlled by a
manual -on occupancy sensor.
§150(k)l 1: Permanently installed luminaires located in rooms or areas other than in kitchens, bathrooms, garages, laundry rooms,
closets, and utility rooms shall be high efficacy luimnaires. EXCEPTION 1: Permanently installed low efficacy luminaires shall be
allowed provided they are controlled by either a dimmer switch that complies with the applicable requirements of §119, or by a manual -
on occupant sensor that complies with the applicable requirements of §119. EXCEPTION 2: Lighting in detached storage building less
than 1000 square feet located on a residential site is not required to comply with §150 k 11.
§150(k)12: Luminaires recessed into insulated ceilings shall be listed for zero clearance insulation contact (IC) by Underwriters
Laboratories or other nationally recognized testing/rating laboratory; and have a label that certifies the lumiunaire is airtight with air
leakage less then 2.0 CFM at 75 Pascals when tested in accordance with ASTM E283; and be sealed with a gasket or caulk between
the luminaire housing and ceiling.
§150(k)l3: Luminaires providing outdoor lighting, including lighting for private patios in low-rise residential buildings with four or more
dwelling units, entrances, balconies, and porches, which are permanently mounted to a residential building or to other buildings on the
same lot shall be high efficacy. EXCEPTION 1: Permanently installed outdoor low efficacy luminaires shall be allowed provided that
they are controlled by a manual on/off switch, a motion sensor not having an override or bypass switch that disables the motion sensor,
and one of the following controls: a photocontrol not having an override or bypass switch that disables the photocontrol; OR an
astronomical time clock not having an override or bypass switch that disables the astronomical time clock; OR an energy management
control system (EMCS) not having an override or bypass switch that allows the luminaire to be always on EXCEPTION 2: Outdoor
luminaires used to comply with Exceptionl to §150(k)13 may be controlled by a temporary override switch which bypasses the motion
sensing function provided that the motion sensor is automatically reactivated within six hours. EXCEPTION 3: Permanently installed
luminaires in or around swimming pool, water features, or other location subject to Article 680 of the California Electric Code need not
be high efficacy luminaires.
§150(k)14: Internally illuminated address signs shall comply with Section 148; OR not contain a screw -base socket, and consume no
more than five watts of power as determined according to §130(d).
§150(k)15: Lighting for parking lots and carports with a total of for 8 or more vehicles per site shall comply with the applicable
requirements in Sections 130, 132, 134, and 147. Lighting for parking garages for 8 or more vehicles shall comply with the applicable
requirements of Sections 130 131, 134, and 146.
§150(k)16: Permanently installed lighting in the enclosed, non -dwelling spaces of low-rise residential buildings with four or more
dwelling units shall be high efficacy luminaires. EXCEPTION: Permanently installed low efficacy luminaires shall be allowed provided
that they are controlled by an occupant sensors certified to comply with the applicable requirements of 119. i
EnergyPro 5.1 by EnergySoft User Number: 2655 RunCode: 2012-01-25711:04:27 ID: Page 11 of 12
HVAC SYSTEM HEATING AND COOLING LOADS SUMMARY
Project Name
EI Rancho Homes Inc.
Date
1/25/2012
System Name
Whole House
Floor Area
1,972
ENGINEERING CHECKS
SYSTEM LOAD
Number of Systems
1
COIL
CFM
Total Room Loads 814
Return Vented Lighting
Return Air Ducts
Return Fan
Ventilation F 0
Supply Fan
Supply Air Ducts
TOTAL SYSTEM LOAD
COOLING
PEAK COIL HTG.
PEAK
Heating System
Sensible
Latent CFM
Sensible
Output per System 86,000
19,489
2,031 491
18,087
Total Output Btuh 86,000
0
Output Btuh/s ft 43.6
1,125
889
Cooling System
0
0
Output per System 58,000
0
0 0
0
Total Output Btuh 58,000
0
2,031
0
Total Output Tons 4.8
1,125j
889
Total Output Btuh/s ft 29.4
Total Output s ft/Ton 408.0
21,739
19,865
Air System
CFM per System
2,055
HVAC EQUIPMENT SELECTION
Airflow cfm
2,055
York GCGD 60S 415 3A 43,919
5,787
86,000
Airflow cfm/s ft
1.04
Airflow cfm/Ton
425.2
86,000
Outside Air % 0.0%
Total Adjusted System Output 43,919
(Adjusted for Peak Design conditions)
1 TIME OF SYSTEM PEAK
5,787
Aug 3 PM
Outside Air cfm/s ft 0.00
Note: values above given at ARI conditions
Jan 1 AM
HEATING SYSTEM PSYCHROMETRICS
Airstream Temperatures at Time of Heating Peak
26 OF 70 OF
Outside Air
0 cfm Supply Fan
2,055 cfm
70 OF
70 OF 105 OF
Heating Coil
_
105 OF
ROOM
70 OF
COOLING SYSTEM PSYCHROMETICS Airstream Temperatures at Time of Cooling Peak
112 / 78 OF 79 / 63 OF 79 / 63 OF 55 / 54 OF
Outside Air Arc
0 cfm Supply Fan Cooling Coil 56 / 54 OF
2,055 cfm—-,•,
az.z Bio ROOM
79 / 63 OF 78 / 63 OF
EnergyPro 5.1 by EnergySo/t User Number: 2655 RunCode: 2012-01-25T11:04:27 ID:
Page 12 of 12
Building Materials and
Construction Services
D.B.A Boulder West Components
45491 Golf Center Parkway, Indio, CA 92203
Telephone: (760) 347-3332
Fax: (760) 347-0202
b Nuc
CITY OF LA QUINTA
' BUILDING & SAFETY DEPT.
APPROVED
FOR CONSTRUCTION
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BMC
Avenida Vallejo Residence
12�12�2011
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GREATER THAN T LESS THAN T= LTHJ
8' SETBACK CG's= THJA26
SHEET Building Materials and Construction Services
1 D.B.A. Boulders West Components
OF 45-491 Golf Center Parkway, Indio, CA
1 Building Materials and (760) 347-3332 Fax: (760) 347-0202
Construction Services
CUSTOMER: BMC
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� ®'��/l� ! Va'llejo
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LESS THE T SETBACK CG's= SUR/1_24
GREATER THAN T LESS THAN T= LTHJ
8' SETBACK CG's= THJA26
SHEET Building Materials and Construction Services
1 D.B.A. Boulders West Components
OF 45-491 Golf Center Parkway, Indio, CA
1 Building Materials and (760) 347-3332 Fax: (760) 347-0202
Construction Services
CUSTOMER: BMC
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JOB#:
SCALE:
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( 189) 2x4 Solid Blocks' [GARAGE'
( 30) 2x6 Bevel 3 15/16" LE @ 4:12 "
NOTE: OPEN END JACKS LESS THAN REQUIRE (3) 12d Avenida,
� ®'��/l� ! Va'llejo
Residence
TOE-NAIL @ T.C. 8 B.C. SEE STANDARD JACK DETAIL
LESS THE T SETBACK CG's= SUR/1_24
GREATER THAN T LESS THAN T= LTHJ
8' SETBACK CG's= THJA26
SHEET Building Materials and Construction Services
1 D.B.A. Boulders West Components
OF 45-491 Golf Center Parkway, Indio, CA
1 Building Materials and (760) 347-3332 Fax: (760) 347-0202
Construction Services
CUSTOMER: BMC
JOB NAME: Avenida Vallejo Residence
OPT/ONS.
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DATE: 12/12/2011
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